Dermatopathology Lab

Using  their knowledge and training, our dermatology providers diagnose and  treat the majority of skin conditions by visual examination alone.  However, in certain cases, additional information is helpful to  differentiate between similar-appearing processes to make a more  specific diagnosis (differentiating skin cancer from non-skin cancer or  psoriasis from eczema, for example), or in order to guide more effective  treatment.  In these situations, a biopsy may be recommended for  examination in our on-site laboratory by our in-house Board-Certified  Dermatopathologist,  Dr. Dominick DiMaio and Dr. Sara West.

What is a biopsy?

A biopsy is the process of removing a small sample from the affected skin. This may be done in one of three ways:

  • Shave biopsy – a small section of the skin is “scooped” from the surface and the area heals naturally.

  • Punch biopsy – a “cookie cutter” type of instrument is used to  remove a small plug of skin and a suture or two are placed to close the  wound.

  • Excisional biopsy – a scalpel is used to remove a slightly  larger and deeper area of skin, generally in the case of a larger  abnormal growth. Sutures are then placed to close the wound.

Regardless of the method, the area of skin to be  removed will be numbed before the procedure. This ensures that there  will be no discomfort during the removal. After the biopsy, the site  will be covered with a topical antibiotic and a band-aid. Healing  generally occurs within 2 – 3 weeks.

When is a biopsy recommended?

A biopsy is recommended when a visual examination  alone is insufficiently precise to determine the nature of a skin  condition. A biopsy may also be helpful to differentiate between two  conditions that may appear very similar – for example, it can be used to  distinguish between a cancerous skin growth and a non-cancerous skin  growth or between psoriasis and eczema.

The decision to perform a biopsy is determined by the  patient and provider together – it is important to weigh the expense of  the procedure and the potential discoloration of the skin against the  potential knowledge that can be gained from the testing.

Who examines the skin sample?

All biopsy samples are examined in DSO’s on-site  laboratory by Dr. Sara West or Dr. Dominick DiMaio.  A Dermatopathologist is a physician who has extensive training in the  microscopic examination of skin. The skin sample is embedded in wax,  shaved into very thin slices, and mounted and stained on microscope  slides. The dermatopathologist then examines the prepared slides to make a diagnosis  that will guide selection of treatment options. The on-site laboratory  allows DSO to have excellent quality control over the biopsy samples and  microscope slides. This also ensures a shorter time from biopsy to  diagnosis and treatment, since samples are prepared and examined without  ever leaving DSO.

An amazing amount of information, unavailable in any other way, can be obtained by microscopic examination of a skin sample.

Quick Access