As mentioned earlier, skin samples come in various shapes and sizes from different areas of skin. The categories below outline the surgical procedure used to obtain the skin sample, the specimen shape, and which skin layers are typically involved. This information is useful during the gross examination as well as the various histology processes, including microscopic evaluation.
Most biopsies and excisions that are sent to the histology laboratory for processing include:
Skin shave biopsy: A thin, circular or oval slice of skin is removed (or shaved off) with a razor blade, scalpel, or a razor-like tool for small areas. Only the upper portions of skin are sampled. Curettage, or skin scrapings, are also performed with blade. This method is quick, cost-effective, and the least complicated.
Skin punch biopsy: A cylindrical or conical portion of skin is removed with a sharp, circular boring tool that penetrates and removes deeper portions of skin along with the top two layers. Although the sample is narrow, it does represent all three layers of skin, including the subcutaneous tissue.
Skin excision: Most commonly an elliptical or oval skin portion is cut away with a scalpel. The excision contains the lesion and deeper portions of skin, including the subcutaneous tissue. Excisions are used for both diagnosis and treatment of skin cancers, cysts, and lipomas. Excising tissue affected with skin cancer is the most widely accepted cure for skin cancer.