Skin biopsy

The technique is very much user skill dependent, as some surgeons can remove a small fragment of skin with minimal blemish using any one of the above tools, while others have great difficulty securing the devices.It can be used to diagnose squamous cell carcinoma and melanoma-in-situ, however, the doctor's understanding of the growth of these last two cancers should be considered before one uses the shave method.A small "shave" biopsy often ends up being a large burn defect when the surgeon tries to control the bleeding with electrocautery alone.The blade, which is attached to a pencil-like handle, is rotated down through the epidermis and dermis, and into the subcutaneous fat, producing a cylindrical core of tissue.Long and thin deep incisional biopsy are excellent on the lower extremities as they allow a large amount of tissue to be harvested with minimal tension on the surgical wound.An initial small punch biopsy of a melanoma might say "severe cellular atypia, recommend wider excision".At this point, the clinician can be confident that an excisional biopsy can be performed without risking committing a "false positive" clinical diagnosis.[citation needed] A curettage biopsy can be done on the surface of tumors or on small epidermal lesions with minimal to no topical anesthetic using a round curette blade.Liquid nitrogen or cryotherapy can be used as a topical anesthetic, however, freezing artifacts can severely hamper the diagnosis of malignant skin cancers.The combination of scarring, inflammation, blood vessels, and atypical pigmented streaks seen in these recurrent nevi may result in the dermatoscopic appearance of a melanoma.As the procedure is widely practiced, it is not unusual to see a patient with dozens of scallop scars, with as many as 20% of them showing residual pigmentation.Despite doing a large wedge incision, a pathologist might call the biopsy keratin debris with characteristics of actinic keratosis.