Biopsy of Skin Lesions

This chapter discusses the complexity of issues to consider when determining to do a relatively easy and inexpensive procedure – punch biopsy. Reviewed are lesions appropriate to diagnose with punch, and absolute contraindications to punch, which are few but serious. Review of data and consensus guidelines are clear regarding pigmented lesions highly suspicious for melanoma but there is no clear cut recommendation for type and size of biopsy for a myriad of other lesions. How to obtain a full thickness tissue sample, closure and wound care is outlined. General points of discussion to be reviewed with patients regarding the goal of the procedure and individual considerations are made.