skin biopsy

Clear Cell Acanthoma, also called Acanthome Cellules Claires of Degos and Civatte, Degos Acanthoma and Pale Cell Acanthoma, is a benign skin lesion that often appears on the lower extremities of middle aged and elderly patients. Many Houston area patients with Clear Cell Acanthoma, who come to see Dr. Perri are concerned that they have […]

If you find yourself with a questionable mole, lump, or other growth on your skin, it may be necessary to perform a skin cancer biopsy. The Woodlands and Conroe patients often want to know more about the procedure, such as how to prepare, and what it involves, so they can help put their minds at […]

Although the lip is a very sensitive area, I find that I can deliver local anesthesia in the lip with virtually no pain.  The lip receives a lot of sun damage so skin cancers are commonly found on the lip, especially squamous cell cancer.  Patients who chew tobacco or smoke are very prone to squamous cell cancers arising on […]

Many different skin lesions grow on the eyelid ranging from benign moles to basal cell cancers.  Rashes are also very prevalent on the eyelid especially seborrheic dermatitis and sarcoidosis.  Thus, biopsying the eyelid is very commonplace in the dermatology clinic.  The eyelid can be anesthetized painlessly as the skin is very loose in this area.  […]

Dermatopathology is a very unique field in pathology/dermatology that should be performed by physicians with specialized training in this area and who spend the majority of their professional time as a dermatopathologist.  Dermatologists and pathologists can both become dermatopathologists.  In dermatology residency, 1/3 of all educational time is spent learning dermatopathology.  Those dermatologists who plan […]

Skin cancers can occur in the nail unit so it is necessary to biopsy the nail matrix or nail bed depending on the clinical situation.  The majority of nail unit biopsies involve a biopsy of the nail matrix.  This is one of the most technically difficult biopsies in the integumentary system.  A black vertical line, […]

Hair loss is very difficult to diagnose and treat.  There are two main types of hair loss:  Scarring(Cicatricial) and Non-Scarring.  The categories can be delineated on clinical exam. A scarring hair loss results in the loss of the hair follicles and clinically the ostia (the openings the hairs come out of the scalp) are obliterated […]

A curettage biopsy is rarely used although it is very useful in certain difficult to reach anatomic locations.  A curette is a metal instrument with a long slender handle having a circular tip that is sharp on one side.  It is ideal for doing a biopsy in a crevice such as the conchal bowl of […]

Excisional biopsies are used almost exclusively for skin lesions suspected of being cancer, especially pigmented lesions worrisome for melanoma.  As most melanomas are under 6mm, a punch biopsy can be used to obtain an excisional biopsy.  Although punch biopsies exist that are 8mm and 1cm, I never use a punch biopsy over 6mm.  Punch biopsies […]

Incisional biopsies are used in both the diagnosis of rashes and skin cancer.  These biopsies remove a large ellipse of full thickness skin and are usually repaired with a layer of dermal/subcuticular sutures followed by epidermal interrupted sutures.  This is a rarely used type of biopsy for rashes but it is the preferred type of biopsy for a […]

Shave biopsies are the most useful and versatile type of biopsies utilized by a dermatologist.  I prefer a sterile double edge razor blade which can be flexed to remove flat lesions in their entirety or kept level to remove the upper portion of a lesion.  Some dermatologists use a 15 blade which I find very […]

A punch biopsy involves removing the full thickness of the skin (epidermis, dermis, and fat) in a defined area.  Punch biopsies range in size from 2mm – 1 cm and are circular in shape.  Essentially, they allow the removal of a skin lesion smaller than the diameter of the punch biopsy and can be used […]

Administering local anesthesia with little to no discomfort is not only a very difficult skill to master but is an art.  I pride myself in being able to deliver local anesthesia with minimal discomfort so dermatological procedures can be performed in the office without pain.  Lideocaine 1% with epinephrine is the standard local anesthetic in our clinic.  It is mixed with 1/10 parts sodium […]