If your doctor feels that the spot you have may be suspicious or dangerous – or if you have a rash that has abnormal features or is not responding to standard therapy.

We need to know a few things first:

1. 1. Are you allergic to numbing injections?
   2. Do you tend to bleed or bruise easily? (do you take blood thinners such as Aspirin, Plavix, Coumadin, others?)
   3. Do you have a pacemaker for your heart?
   4. Do you tend to faint easily?

How is it done?

This in-office procedure requires numbing of the skin (by injection usually). The biopsy is then done by removal of a small sample by either shave (to sample surface of the spot), punch or deep (both also sample deeper layers) techniques. The specific procedure best suited for you will be determined by the doctor.  Wound closure can be done by suturing or by using a chemical to seal blood vessels.

Procedure risks include:

• Bruising
• Recurrence
• Infection
• Color change
• Keloids / Scarring

Procedure types:

1. Shave biopsy: surface sampling of the spot but deeper portions still persist

• • Advantages: minimal risk of scarring, rapid healing (like a scratch mark)
  • Disadvantages: risk of recurrence; for dark marks the darkening may persist

1. Deeper biopsies are of 2 types:

• • Punch biopsy: samples surface and deeper skin in a small diameter (typically 3-4 mm)
  • Incisional biopy: samples surface and deeper skin in a larger area

These usually require sutures for closure and will leave a surgical line scar. Further removal will be required if the report shows the spot is potentially dangerous.

1. Complete removal

• • Deep elliptical: performed by cutting along the edges of the spot in an ellipse or football shape, removing the block of tissue, and closing with sutures
  • Curettage: surgical scraping procedure used for skin tumors where the abnormality is on skin surface (not extending into deeper parts of skin tissue).

Taking care of your wound after biopsy:

• Cleanse gently with soap and water once a day is enough
• Apply petrolatum or antibiotic ointment twice daily (eg. Polysporin, Fucidin, Bactroban)
• Do not allow your wound to dry out or develop crust or scab – this will slow healing
• Cover with light dressing or bandage for the 1^st week
• Signs of possible wound problems (please call the office or proceed to emergency if any develop within first 3 days of surgery)
  • Increasing pain, redness at wound; fever, chills, or purulent discharge at wound – may indicate wound infection
  • Sutures or wound comes apart – can be resutured if done within 24-48 hrs

A follow-up visit for wound check-up and to discuss the report of the biopsy should be booked immediately after the procedure