How is biopsy performed in the evaluation of cutaneous squamous cell carcinoma (cSCC)?

Updated: Jul 08, 2020
  • Author: Talib Najjar, DMD, MDS, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Whichever biopsy method is chosen, the following principles should be observed:

  • The biopsy should contain the full thickness of the skin in order to evaluate the depth of the lesion; therefore, a shave biopsy is generally not recommended when malignancy is suspected

  • The biopsy should be centered over the transition point between normal and involved skin, thereby providing a reference for comparison by the pathologist

  • When possible, incisions should be made parallel to the natural lines of skin tension (Langer lines) for optimal cosmetic outcome

  • For punch biopsies, stretching the skin perpendicular to the Langer lines creates an ellipse oriented in this optimal direction and facilitates closure

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