DR SANDY STEELE
Biopsies
Biopsies: These are performed under local anaesthetic and involve removing a small portion of skin to determine if serious pathology is present.
If your doctor has advised you to have a biopsy due to suspicion of malignancy, it is very important to have this completed. If the lesion is a skin cancer/malignancy, and it is not diagnosed the opportunity for appropriate treatment may be lost. If is very important to present for review regarding any suspicious lesions, changes, or concerns.
If your biopsy reveals malignancy then further treatment will be recommended.
One of the advantages of doing a biopsy is not only does it confirm if the lesion is a skin cancer – it can also advise us as to the lesion subtype and management options.
Removal of a malignant cancer of skin often necessitates a wide deep excision and biopsies are performed to avoid these larger procedures, if in fact, the skin tumour is benign.
A biopsy may not always be representative of the entirety of the lesion, if you have had a biopsy and have persisting concerns about the scar or lesion, please advise your doctor.
Types of Biopsy that are common:
Depending on the clinical assessment of the lesion, your Doctor may recommend a biopsy appropriate to determine the diagnosis:
A punch biopsy or incisional biopsy may have one or a few stitches, most small punch biopsies do not require stiches unless there is bleeding that needs to be controlled.
A shave biopsy /excision will be like a “graze” and will not have stitches. A small visible scar (usually paler than the original skin) can be expected.
Curettage and Cautery: This is a superficial skin surgery similar to a shave biopsy followed by treatment of the base of the shave by gentle curetting ("scraping”) as well as cauterisation with a minute electric current or sometimes cryotherapy. It can be expected to take about two weeks to heal and will need to be covered with a dressing during this time.
For more information on biopsies: Dermnet NZ
Potential Complications:
Expected potential complications for a biopsy may include bleeding, bruising (especially around the eyes), swelling, and tenderness. Skin infection and scarring can also occur.​
Post-Biopsy Skin Infection
Biopsy sites can develop a skin infection - especially if a patient is high risk for skin infections due to medical conditions such as diabetes.
If your biopsy is not healing as expected, or becomes red, hot, tender, swollen or develops a purulent exudate (pus), or you feel unwell or develop a fever - please advise your doctor immediately.
Other Complications:
Scarring
A scar from a biopsy is expected. Rarely complications such as keloid scarring can occur. A raised, tender scar is called a hypertrophic scar (or Keloid). This rarely occurs and is more likely at certain sites (e.g., over the breastbone/sternum or shoulder) and in certain persons. Notify your doctor if you have a personal history of keloid scarring. The tenderness usually settles with time but the appearance may persist. Such scars are generally best treated conservatively, as further surgery may aggravate the problem. Hypertrophic/Keloid scars can be treated by the doctor with injections of cortisone into the scar tissue. A scar is expected, but some scarring is more than expected, please notify Dr Sandy if you are unsure if the scar is normal. Massaging the scar with Vaseline or silicone scar gel can improve the appearance of the scar. Massage firmly into the scar for 30 seconds 2 – 3 times a day for 3 or more months for improved results.
Taping the scar with medical tape or silicone scar tape can also assist to improve scarring.
Rarely biopsies can cause injury to adjacent structures or nerves, and rarely patients can have allergic reactions to local anaesthetic, Band-Aids/dressings.
If you have any concerns with scarring, recurrent or changing lesions, problems with wound healing: PLEASE ADVISE YOUR DOCTOR IMMEDIATELY