PUNCH BIOPSIES:
A skin biopsy is performed in order to send a sample of skin to the pathologists to verify a diagnosis. Biopsies of the skin are usually performed straight away during your consultation. After examining the rash or a lesion that you or the dermatologist finds concerning, you will be asked questions regarding its history. We will then determine whether a skin biopsy is necessary. In the case of a rash, a fresh, but well-developed, lesion will be chosen. We will do our best to avoid biopsies in cosmetically sensitive sites although this is not always possible. In the case of a potential skin malignancy, a total body skin examination will be carried out and the most worrisome lesion(s) will be biopsied.
When the local anaesthetic is carried out, you will feel a slight pinch of the needle, and then a brief burning sensation as the anaesthetic is injected. A feeling of pressure may also occur when the local anaesthesia is injected into a relatively taut area of skin such as the fingers or toes. If you are apprehensive regarding the injection, a topical anaesthetic can be applied 30 minutes prior to the procedure to reduce the associated pain.
Once the area is numb, the punch biopsy will be carried out. A punch biopsy involves the use of a circular blade which looks like a cookie cutter to remove a small section of the skin (usually between 2-4mm in diameter) including the deeper layers of the skin (down to the fat). It enters the skin with a gentle turning motion and sutures or stitches will then be used to close the small wound.