Incisional Biopsy

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 panniculitis, inflammation of the fat.  An incisional biopsy allows the dermatopathologist to see a large portion of the subcutaneous tissue so the type and pattern of the inflammation can be delineated.  For skin cancer, an incisional biopsy is especially useful for cutaneous lymphomas/leukemias where a large portion of the dermis and subcutaneous tissue needs to be evaluated.  Also, very large pigmented lesions, which can not be excised completely can be biopsied in this fashion so the dermatopathologist can evaluate a larger portion of the pigmented lesion.