Goals

The goal of an excision biopsy is to remove a full-thickness skin lesion for diagnosis or cosmetic purposes while producing a cosmetically acceptable linear scar.

Background

Excision biopsies are done through an elliptical excision around a lesion. An elliptical shape can be described as an extended oval or the shape of an eye. The elliptical shape allows for linear repair that can be aligned easily and a cosmetically appealing result.  Excision biopsies allow for full thickness removal of the dermis with extension into the subcutaneous fat. Excision biopsies are done to allow for pathologic examination of a lesion, removal of a lesion for cosmetic purposes, or for the biopsy of inflammatory disorders. Elliptical excision biopsies result in a linear scar and must be done in anatomical locations were a linear scar is acceptable – if a patient is not comfortable with this, referral may be warranted.

Contraindications

Referral to dermatology may be warranted in the following situations:

• Anatomic location where a linear scar is deemed unacceptable
• History of keloids or hypertrophic scars
• Impaired hemostasis
• Diabetes with history of poor wound healing
• Immunosuppression
• Potential for malignant lesion