What is a skin biopsy?
A skin biopsy is a procedure in which a physician removes a small sample of tissue to have it tested. This skin sample may help your doctor diagnose a metabolic disease. The skin sample may be removed by a technique known as a punch biopsy.
Before the procedure
Generally, there is no special preparation needed before a skin biopsy.
During the procedure
The doctor will first cleanse the biopsy site. He or she will then numb the skin by using an anesthetic (pain-relieving) spray, cream, or injection to minimize pain during the procedure and will then remove two small (3 mm) pieces of skin. A nurse may apply pressure to the area to stop the bleeding. The doctor will then close the incision, using adhesive Steri-Strips ™ (which look like small pieces of tape). The entire biopsy procedure lasts about 15 minutes.
After the procedure
- You will remain in the treatment area for a short time for observation.
- You may have some soreness around the biopsied area for one to two weeks.
- If Steri-Strips ™ were used to close the incision, do not remove them. They will gradually fall off on their own.
- You should expect a small scar from the biopsy.
- Ask your doctor when you should come back for a follow-up visit.
How the skin sample is tested
The skin sample will usually be sent to two Cleveland Clinic labs for microscopic examination (electron microscopy) and fibroblast culture. The electron microscopy report is usually available 10 working days after the procedure. Call your doctor’s office to get the results.
The fibroblast culture is a way of establishing a "clone" of skin cells that can be used for specific biochemical testing. Skin tissue is different from muscle, brain, heart, and liver tissue, so any results obtained may or may not be helpful in aiding in the diagnosis.
Further testing on this clone of cells is not always done. If appropriate, the cells may be frozen for further testing.
Skin cells in culture can stop growing or die at any time. If they die, the entire biopsy procedure will need to be repeated to attempt to establish a clone of skin cells.
Skin cells grow at their own pace, and nothing can be done to make them grow any faster. Sometimes the skin cells grow fast enough to be sent to another lab in approximately two weeks; other times it may take three months or longer .
Once the cells have grown enough to be sent to another lab, they must be first tested to make sure they are not contaminated with any bacteria. This can take another five to seven working days.
The specific biochemical testing on the clone of skin cells is not done at Cleveland Clinic. Depending on which test is ordered, the skin sample will be sent to one of several laboratories that specialize in that specific test.
Skin samples are sent by courier service or by overnight mail service to the specialized laboratory. Note: Overnight mail services do not guarantee the safe arrival of human tissues, so if the specimen gets lost, misrouted, or otherwise destroyed, there is nothing that can be done. However, in the last three years, this has occurred three times. Unfortunately, there is no practical alternative to using a commercial carrier.
When the cells arrive at the testing laboratory, they must be further grown to a volume that can be used for the test. Depending on the growth rate of the cells, this can take one week to several months.
Once the cells have grown to a necessary volume, the test is run. The lab will keep a small amount of cells aside in case your doctor requests more tests. The lab will fax the test results to your doctor as soon as the report is generated. The test results may or may not be diagnostic.
If your doctor determines that the test results are not diagnostic, he or she may order a second test. In this case, the cells used for the first test cannot be used over again, and the cells not used for the first test would be regrown.
When to call the doctor
- Call your doctor if you have bleeding that can’t be stopped by applying pressure.
- Call your doctor if you have any questions or concerns after the procedure.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/5/2006...#7146
