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Punch biopsy: definition, types and uses

A punch biopsy is a procedure used to obtain a sample of tissue from the body. Punch biopsies are often used to diagnose skin cancer. A small sample of skin is taken and then analyzed under a microscope in a laboratory. Punch biopsies can also be used to diagnose cervical cancer, vulvar cancer, or conditions that can lead to cancer.

This article will describe what to expect during a punch biopsy, as well as the risks and the recovery process.

Ivan Balvan


Definition

A punch biopsy is a procedure that uses a pointed, hollow instrument to remove a sample of tissue. The sample size is about the same as a pencil eraser and is examined under a microscope by a pathologist in a laboratory. The sample can then be used to diagnose certain types of cancer.

Process

A punch biopsy is performed in an outpatient clinic and takes about 15 minutes.

For this in-office procedure, your healthcare provider will start by cleaning the skin area with an alcohol wipe or disinfectant. They will then inject a local anesthetic into the skin to numb the area of ​​the biopsy.

To perform a punch biopsy, your healthcare provider will insert the hollow, circular scalpel into the skin and gently rotate it clockwise and counterclockwise. watch to reduce the fatty tissue layer under the skin. A punch biopsy usually cuts about 4 millimeters into the skin.

After the tissue sample is removed, your healthcare provider may place stitches to prevent bleeding. This will depend on the depth of the biopsy site and the amount of bleeding. They will tell you when to expect results and how to follow up.

Who did it?

Most skin biopsies are performed by a dermatologist. For a cervical biopsy, your gynecologist will likely handle the procedure. Other healthcare providers who can diagnose conditions, such as physician assistants and nurse practitioners, may also perform a punch biopsy.

Types of skin biopsies

In addition to a punch biopsy, other common skin biopsy options include:

  • Shave biopsy: The upper layers of the skin are shaved with a scalpel.
  • Local circumcision: The skin sample is taken with a scalpel.
  • Mohs surgery: Thin layers of skin are removed by a surgeon and then examined under a microscope during the procedure.
  • Curettage and electrodesiccation: The skin sample is scraped off with a tool called a curette, then an electric needle called an electrode kills any remaining cancer cells.

Uses

A punch biopsy is used to diagnose rashes and skin conditions that go deeper than the epidermis. A punch biopsy is also used to diagnose benign growths, inflammatory lesions, skin conditions (eczema and psoriasis), and certain types of skin cancer (melanoma).

How to prepare

To prepare for a punch biopsy, sit down and talk with your healthcare provider about what to expect. Ask questions and take notes to help you remember details.

Make sure your practitioner has an up-to-date list of your medications and allergies. Let them know if you have a bleeding disorder or are taking blood thinners, as this could lead to a dangerous amount of bleeding after the biopsy.

To prepare for a cervical punch biopsy, avoid sex and the use of tampons or vaginal creams for 24 hours before the procedure.

Eligibility

Your healthcare provider will discuss with you whether you are eligible for a punch biopsy based on the results of your physical exam and your general health. A punch biopsy is usually recommended when cancer is suspected. If you have a bleeding disorder, your healthcare professional will work with you to determine if a punch biopsy is safe for you.

Results/Recovery

After a punch biopsy, your healthcare provider will explain how your tissue sample will be tested and when to expect the results.

Once the biopsy is complete, your practitioner will cover the area with a bandage and give you instructions on how to care for it at home. If they placed stitches, ask if the stitches need to be removed or if they will dissolve on their own. At home, keep your biopsy site clean, dry, and covered until it heals.

Warnings/Contraindications

Possible risks of a punch biopsy include bleeding, scarring, and infection. If your biopsy site won’t stop bleeding or shows signs of infection, call your healthcare provider right away. Signs of an infection include worsening pain, swelling, redness, discharge of pus, and fever.

If you have a bleeding disorder or are currently taking blood thinners, a punch biopsy may not be safe for you.

Summary

A punch biopsy is a diagnostic procedure used to detect rashes, benign growths, and chronic skin conditions. It can also be used to diagnose skin conditions that may lead to cancer. During a punch biopsy, your healthcare provider will use a hollow, circular scalpel to remove a tissue sample. The sample is then examined under a microscope in a laboratory to look for signs of cancer.

A word from Verywell

If you’re preparing for a punch biopsy, you may not know what to expect. It’s helpful to remember that your healthcare provider will numb the biopsy area, so you shouldn’t expect any pain during the procedure. Once the biopsy is sent to the lab, it may take a few days to get your results. Talk to your healthcare provider about any concerns you have.

Frequently Asked Questions

  • Who performs a punch biopsy?

    A punch biopsy is usually performed by a doctor. Nurse practitioners and physician assistants may also perform punch biopsies.

  • Does a punch biopsy hurt?

    Before performing a punch biopsy, your healthcare provider will numb the skin with a local anesthetic. Do not expect pain during the biopsy. Afterwards, the area may be painful. Talk to your healthcare professional about over-the-counter pain relievers that you can safely take.

  • How do I know if a punch biopsy is infected?

    Common signs of an infection in a biopsy site include increasing pain, redness, swelling, discharge of pus, or fever. If you experience any of these symptoms, call your healthcare provider.