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Also known as "scoop", "scallop", or "shave" excisional biopsy, [3] or "shave excision". A trend has occurred in dermatology over the last 10 years with the advocacy of a deep shave excision of a pigmented lesion [4] [5] [6] An author published the result of this method and advocated it as better than standard excision and less time-consuming.
There are four main types of skin biopsies: shave biopsy, punch biopsy, excisional biopsy, and incisional biopsy. The choice of the different skin biopsies is dependent on the suspected diagnosis of the skin lesion. Like most biopsies, patient consent and anesthesia (usually lidocaine injected into the skin) are prerequisites. [citation needed]
Shave biopsy is a biopsy procedure in which a skin abnormality and a thin layer of surrounding skin are removed with a small blade for examination under a microscope. Shave biopsies are not effective in treating melanomas, but can provide a reasonably safe and accurate initial diagnosis. [1] Surgical sutures are not needed with this procedure. [2]
Generally a skin biopsy: For punch biopsies, a size of 4 mm is preferred for most inflammatory dermatoses. [2] Panniculitis or cutaneous lymphoproliferative disorders: 6 mm punch biopsy or skin excision. [2] A superficial or shave biopsy is regarded as insufficient. [2]
It is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code. [19] In the past, AMA offered a limited search of the CPT manual for personal, non-commercial use on its web site. [20] CPT codes can be looked up on the AAPC (American Academy of Professional Coders) website. [21]
The biopsy material is then sent to a laboratory to be evaluated by a pathologist. A skin biopsy can be a punch, shave, or complete excision. The complete excision is the preferred method, but a punch biopsy can suffice if the patient has cosmetic concerns (i.e. the patient does not want a scar) and the lesion is small.
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First, a diagnosis must be made. If the lesion is a seborrheic keratosis, then shave excision, electrodesiccation, or cryosurgery may be performed, usually leaving very little, if any scarring. If the lesion is suspected to be skin cancer, a skin biopsy must be done before considering removal. This is unless an excisional biopsy is warranted.