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© Copyright | Dr Juliet Williams
Sometimes a biopsy is needed to help to make a diagnosis of what is causing a rash or skin lesion.
Dr Williams will explain the procedure to you, including all the serious or frequently occurring complications. You will have an opportunity to ask any questions you may have before signing a form to give your consent to proceed. The procedure is performed with an aseptic technique to prevent infection and the first step is cleaning the skin. Local anaesthetic is used to numb the area prior to the procedure. A dressing is applied and post-operative instructions given.
Punch biopsy or excision: this involves removal of a skin sample a few millimetres in diameter but of full thickness with a special instrument. For very small skin lesions, it is possible to remove them completely, known as punch excision, and the technique can also be used to diagnose a rash or larger skin lesions.
Shave biopsy or excision: this involves removing the upper part of a skin lesion for diagnosis or to completely remove the portion of a lesion that protrudes from the skin. It usually gives a more aesthetically-pleasing result than full excision.
Excision: the full thickness of the skin lesion is removed with a margin of the surrounding healthy skin and sent to be tested. The skin is closed with stitches and Dr Williams will advise when these should be removed depending on the site.
Curettage: using a special cutting instrument with a circular edge, Dr Williams can scoop out the skin lesion as it is softer than the surrounding healthy skin. Heat is then applied to seal the blood vessels and stop bleeding.
The local anaesthetic injection stings and there may be discomfort afterwards when it wears off. There will be bleeding which can usually be controlled by applying pressure or with cautery. Any wound can become infected and Dr Williams may advise topical or oral antibiotics but usually, this is not necessary. There will be a scar which normally fades and flattens over time but sometimes scars become itchy or lumpy, which is termed a hypertrophic or keloid scar.
You should be able to resume normal activities immediately afterwards but it may be advisable to make arrangements not to drive yourself home. It is recommended to keep the area dry for 24 to 48 hours to reduce the risk of developing an infection. If stitches are used these will need to be removed between 5 to 14 days following the procedure and Dr Williams will advise on the correct timescale in your case.
If you have any concerns about the wound please contact Dr Williams, or the outpatient nurses can perform a wound check and advise.
Call 01483 555 907 to arrange a consultation with Dr Williams.