Definition & Overview

A skin biopsy, which can be either a subcutaneous tissue biopsy or a mucous membrane biopsy, is a procedure in which a sample of the skin is taken for further laboratory analysis to diagnose suspected skin disorders, including skin cancer. There are many ways to obtain the said soft-tissue samples, including a method combined with simple closure of the wound.

Who Should Undergo and Expected Results

Skin biopsy of subcutaneous tissue and/or mucous membrane is performed if skin disorders are suspected due to unusual symptoms or changes in the skin, such as:

  • Discolouration of the skin
  • Failure of the skin to heal after an injury
  • Abnormal skin lesions
  • Lesions that bleed easily
  • Skin ulcers


Some of the skin disorders that can be diagnosed through this procedure include skin cancers such as basal cell carcinoma, squamous cell carcinoma, and melanoma. The procedure can thus aid in early treatment that can raise the patient’s chances of recovery and survival.

There are two main types of skin biopsy, namely:

  • Subcutaneous tissue biopsy, in which a sample of tissue is taken immediately beneath the skin.

  • Mucous membrane biopsy – Also known as a mucosal biopsy, this procedure is performed to remove a small piece of skin from the mucous membrane located inside the mouth. This is highly effective in detecting organisms that may cause or have already caused an infection.


In addition, the procedure can help determine whether the skin plays a role in some of the patient’s other medical conditions, such as autoimmune, endocrine, or inflammatory disorders.

How is the Procedure Performed?

There are four common methods used in obtaining skin biopsy samples of the subcutaneous tissue and/or mucous membrane, namely:

  • Punch biopsy – This involves inserting a special circular hollow tool called a punch deep into the skin to obtain the needed sample.
  • Excisional – This removes a skin lesion completely and is ideal for lesions that are relatively small in size. Thus, the procedure can be performed both for diagnostic and therapeutic purposes.
  • Incisional – This is performed by removing a part of a suspected skin lesion and is recommended in cases that involve lesions that are too large for a total excisional biopsy.


Regardless of how the biopsy is taken, the procedure generally follows the same steps, beginning with the administration of anaesthesia and an antibacterial solution to cleanse the target area. Anaesthesia can be either local or general, depending on the size and location of the lesions and the severity of the symptoms.

Possible Risks and Complications

A skin biopsy of the subcutaneous tissue and/or mucous membrane with simple closure can cause infection and bleeding, which are common in any procedure that involves a skin incision. Patients can also expect to feel some pain, which can occur in varying degrees or severity depending on which part of the body is involved.

Also, in some cases, the obtained sample is not enough to produce a definite diagnosis. Thus, the procedure has to be repeated.

References:

  • Nischal U, Nischal KC, Khopkar U. “Techniques of skin biopsy and practical considerations.” J Cutan Aesthet Surg. 2008 Jul-Dec; 1(2): 107-111. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840913/
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