Bolognia says. For example, all pathology labs use special stains to determine specific types of cells, but Yale Medicine's dermatopathology lab has more than stains just for skin. If Dr. Bolognia biopsies a nevus mole with a darker portion that is clinically worrisome, the technicians will put special ink on the dark area.
This ensures that the dermatopathologist will carefully assess the area of concern to the clinician. Their expertise is often sought by dermatologists, surgeons and medical oncologists throughout New England.
If the dermatopathologist has questions about the patient, including specific medications or medical diseases, he or she calls the dermatologist who performed the biopsy before issuing the report. This is not common in general pathology labs, and is not always routine in other specialized dermatopathology labs.
Yale Medicine dermatopathologists are also given the opportunity to go with the dermatologist on rounds, which gives them insight into patient care. If the results of the skin biopsy are benign, the dermatologist usually has results ready to share with the patient within a week. If the pathologic diagnosis is a benign tumor, then the patient is usually notified by mail or electronically via MyChart. In addition, those patients who sign up for MyChart have access to the actual pathology report as do their Yale Medicine physicians.
When results of a skin biopsy show a skin cancer or another condition that requires an explanation , then a call is placed to the patient.
When the biopsy returns as a melanoma, the area must be re-excised with a goal of obtaining clear margins. Depending upon the depth of invasion of the melanoma, a discussion is also held regarding sentinel lymph node biopsy. The oncology section at Yale Medicine has an active melanoma unit and has expertise in a wide range of clinical presentations.
Skip to Main Content. Types of biopsies include: Shave biopsies are employed when the dermatologist suspects that the condition or tumor involves primarily the top layer of the skin the epidermis. The biopsy specimen includes the epidermis and sometimes the superficial portion of the dermis the second layer of skin.
The scalpel blade is slightly angled when performing this procedure. Saucerization is performed if the dermatologist envisions that the disease or tumor extends into the upper or mid dermis.
In this type of biopsy, the edge of the blade is at a greater angle relative to the surface of the skin. There are different types of skin biopsies. The doctor will choose one based on the suspected type of skin cancer, where it is on your body, its size, and other factors. Any biopsy will probably leave at least a small scar. Different methods can result in different scars, so if this is a concern, ask your doctor about possible scarring before the biopsy is done.
Skin biopsies are done using a local anesthetic numbing medicine , which is injected into the area with a very small needle. You will probably feel a small prick and a little stinging as the medicine is injected, but you should not feel any pain during the biopsy. For animated views of some of these procedures, see Skin Biopsy and Treatment Procedures. For a shave biopsy , the doctor shaves off the top layers of the skin with a small surgical blade. Bleeding from the biopsy site is then stopped by applying an ointment or a chemical that stops bleeding, or by using a small electrical current to cauterize the wound.
For a punch biopsy , the doctor uses a tool that looks like a tiny round cookie cutter to remove a deeper sample of skin. The doctor rotates the punch biopsy tool on the skin until it cuts through all the layers of the skin.
The sample is removed and the edges of the biopsy site are often stitched together. To examine a tumor that may have grown into deeper layers of the skin, the doctor may use an excisional or less often, an incisional biopsy. For these types of biopsies, a surgical knife is used to cut through the full thickness of skin. If bleeding continues, apply pressure for another 20 minutes. If bleeding still continues after that, contact your doctor.
All biopsies cause a small scar. Some people develop a prominent, raised scar keloid. The risk of this is increased when a biopsy is done on the neck or upper torso, such as the back or chest. Scars fade gradually. The scar's permanent color will be evident one or two years after the biopsy. Avoid bumping the area or doing activities that stretch the skin.
Stretching the skin could cause the wound to bleed or enlarge the scar. Don't soak in a bathtub, swimming pool or hot tub until your doctor says it's OK — usually about seven days after the procedure.
Healing of the wound can take several weeks, but is usually complete within two months. Wounds on the legs and feet tend to heal slower than those on other areas of the body. Clean the biopsy site two times a day unless it's on your scalp — then clean it once a day. Follow these steps:.
Continue wound care until the stitches are removed or, if you don't have stitches, until the skin is healed. Your doctor sends the skin biopsy sample to a laboratory for testing. Results may take several days or longer, sometimes up to months, depending on the type of biopsy and the lab's procedures.
Your doctor may schedule an appointment to discuss the results. You might want to bring along a family member or friend to help you absorb all the information. Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.
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