Surgical
A skin biopsy is a medical procedure used to diagnose various skin conditions and diseases by removing a small sample of skin cells for laboratory testing. This simple yet effective diagnostic tool helps our dermatologists identify the underlying causes of skin abnormalities, such as rashes, lesions, or suspicious growths.
The three main types of skin biopsies are shave biopsy, punch biopsy, and excisional biopsy, each tailored to specific situations depending on the location, size, and depth of the affected area. In a shave biopsy, a razor-like tool is used to gently scrape off the top layers of skin, usually without requiring stitches. A punch biopsy involves using a circular cutting tool to remove a small, cylindrical core of skin, including deeper layers like the epidermis, dermis, and sometimes the uppermost layer of subcutaneous fat. This method may require stitches to close the wound. Lastly, an excisional biopsy employs a scalpel to remove an entire lump or irregularly shaped patch of skin, along with a margin of healthy tissue and deeper skin layers, often necessitating stitches for proper healing.
The choice of biopsy technique depends on the patient’s specific symptoms, the extent of the affected area, and the suspected diagnosis. A biopsy is performed in our office using local anesthesia to numb the area. Soreness and rarely some pain, tenderness and swelling in the treatment area can be expected for a few days.The excised tissue sample is sent to a pathology lab where a specialized doctor called a dermatopathologist examines it under a microscope to determine the appropriate diagnosis.
Skin cancer excision is a medical procedure for removing skin cancers. During this procedure, the dermatologist carefully cuts out the entire tumor along with a recommended margin of surrounding healthy tissue to ensure complete removal. It is performed in our office using local anesthesia to numb the area. The incision is then closed with stitches to allow proper healing.
Patients are able to go home the same day as the procedure. Some pain, tenderness and swelling in the treatment area can be expected for a few days after surgery but usually resolves quickly. The stitches are removed by the doctor 7 to 14 days later, after the incision has healed sufficiently.
The excised tissue sample is sent to a pathology lab where a specialized doctor called a dermatopathologist examines it under a microscope. This is to definitively confirm that the entire tumor has been successfully removed with clear margins and no cancerous cells remain. Receiving the final pathology results usually takes several days up to two weeks.
Mohs micrographic surgery is a highly precise, state-of-the-art procedure for treating common types of skin cancer, including basal cell carcinomas and squamous cell carcinomas. This meticulous surgical technique, developed by Dr. Frederic Mohs in the 1930s, involves progressively removing thin layers of cancerous skin and examining each layer microscopically until only healthy, cancer-free tissue remains.
The process begins with the surgeon, who is typically a specially trained dermatologist or plastic surgeon, meticulously mapping out and removing a thin layer of tissue around the visible tumor. This layer is carefully divided into sections, color-coded with dyes, and diagrammed to precisely document the location of each section. The surgeon then examines these sections under a microscope to determine if any cancerous cells are present at the margins. If cancer cells are detected, the surgeon uses the color-coded map to remove another thin layer of skin from the exact area where the cancer persists, leaving the rest of the healthy tissue intact. This process is repeated as many times as necessary until the surgeon confirms that all cancerous roots have been eliminated.
Often, the procedure takes less than four hours, however, we recommend planning for the procedure to take the whole day. By systematically removing and analyzing each ultra-thin layer one by one, Mohs surgery ensures the complete removal of the skin cancer while sparing as much normal, healthy tissue as possible. This maximizes the functional and cosmetic outcome and minimizes the risk of recurrence, resulting in cure rates approaching 99% for certain types of skin cancer.
