Skin Biopsy & Diagnostic Analysis

What is a Skin Biopsy?

A skin biopsy is a minor surgical procedure in which a small sample of skin is removed and examined under a microscope. It is the gold-standard method for diagnosing skin cancer, inflammatory rashes, autoimmune conditions, and rare skin diseases. For lesion assessment, see also dermatoscopy.

At Skinhorizon Clinic, biopsies are performed exclusively by our consultant dermatologist in a sterile, controlled setting. The tissue is then analysed by a consultant dermatopathologist, ensuring the highest diagnostic accuracy. This partnership between clinical expertise and laboratory analysis provides clarity, guiding safe and effective treatment.

When is it recommended?

Biopsy is advised when a skin condition cannot be diagnosed confidently on clinical grounds alone. Common indications include:

• Suspicious moles: Possible melanoma or atypical naevus
• Precancerous lesions: actinic keratosis, Bowen’s disease
• Skin cancers: basal cell carcinoma, other skin cancers
• Unexplained rashes: psoriasis, eczema, drug eruptions
• Autoimmune/auto-inflammatory: cutaneous lupus, vasculitis, lichen planus
• Hair & scalp disorders: lichen planopilaris, alopecia areata
• Infections: Deep fungal or atypical infections (consider skin swab test when appropriate)

In many cases, biopsy is essential to confirm diagnosis, stage disease, and plan appropriate management.

Types of Skin Biopsy

• Punch biopsy: A circular blade removes a small core of skin (ideal for rashes and autoimmune conditions).
• Shave biopsy: A thin slice of a raised lesion is removed (useful for superficial cancers, seborrhoeic keratoses, warts).
• Excisional biopsy: The entire lesion is removed with a margin (recommended for suspected melanoma or larger lesions).
• Incisional biopsy: A portion of a large lesion is removed when full excision is impractical.

How it works

1. Consultation: Clinical examination and discussion of concerns.
2. Consent: Risks, benefits, and aftercare explained.
3. Local anaesthetic: Injection to numb the area.
4. Biopsy procedure: Punch, shave, or excision performed depending on indication.
5. Specimen handling: Tissue sent to dermatopathology for analysis.
6. Aftercare: Wound dressed, aftercare advice provided.
7. Results: Consultant reviews findings with you in follow-up.

What can it help diagnose?

A biopsy is the definitive test for many skin conditions. It helps differentiate between benign, precancerous, and malignant lesions, and clarifies causes of chronic rashes. Examples include:

• Melanoma vs benign mole (see melanoma in situ)
• Basal cell carcinoma vs seborrhoeic keratosis
• Psoriasis vs eczema vs drug eruption
• Lupus erythematosus vs lichen planus
• Cicatricial alopecia vs alopecia areata
• Deep fungal vs bacterial infection

Preparation

• Inform your consultant about blood thinners, aspirin, or bleeding disorders.
• Avoid applying creams or ointments to the biopsy site beforehand.
• Wear loose clothing to reduce friction on the wound after the procedure.
• Arrange for follow-up to discuss results, usually within 1–2 weeks.

Safety & limitations

Skin biopsy is a safe, minor procedure. Risks include mild bleeding, infection, scarring, or pigment change at the site. Limitations: a biopsy samples only part of a lesion, so rarely further excision may be needed for complete diagnosis or treatment.

Results & follow-up

Histopathology reports are typically available within 1–2 weeks. Your consultant will review results, explain findings, and advise next steps — whether reassurance, medication, surgical excision, or referral to oncology if required. For treatment pathways, see mole removal and precancerous & cancerous lesion treatment.

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Disclaimer: Diagnostic tests at Skinhorizon are provided only where clinically appropriate and must be interpreted by a qualified healthcare professional. Results alone do not replace a medical diagnosis, and further consultation may be required.