The Skin Biopsy

University of California, San Francisco

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The Skin Biopsy

If your doctor finds a lesion that is suspicious, a sample of skin might be removed to look at under a microscope. This is called a skin biopsy. There are several different ways to perform a skin biopsy. The choice depends on the type of skin cancer, where it is on the body, and the size of the affected area. Looking at tissue under the microscope is the most definitive method to diagnose a skin cancer.

Shave Biopsy
Punch Biopsy
Incisional/Excisional Biopsy

Shave Biopsy

The skin is numbed with local anesthesia. A sharp blade is used to shave off a thin slice of skin containing the top layer of skin, the epidermis, and a portion of the bottom layer of skin, the dermis.

Schematic Representation of a shave biopsy

Punch Biopsy

The skin is numbed with local anesthesia. A sharp, circular blade is used to remove a cylindrical core of skin and all skin layers down to the subcutaneous fat layer. The wound may be closed with stitches.

Schematic Representation of a punch biopsy

Incisional/Excisional Biopsy

The skin is anesthetized (numbed) with local anesthesia. A scalpel is used to remove a portion of the tumor (incisional biopsy) or the entire tumor (excisional biopsy). The incision site is closed with stitches.

Excisional Biopsy

This suspicious lesion was 1.5cm in diameter. It was removed along the lines indicated with a thin margin of normal skin. This was examined under a microscope and was diagnosed as a melanoma.