How to perform a skin biopsy

Kirsty JL Wark, Saxon D Smith and Deshan F Sebaratnam
Med J Aust 2020; 212 (4): . || doi: 10.5694/mja2.50473
Published online: 2 March 2020

The skin has more disease processes than any other organ system in medicine, with over 3000 dermatological conditions described.1 Teaching of dermatology is often neglected in medical training internationally, and most doctors feel ill‐equipped to diagnose cutaneous pathology.2 Compounding this, limitations in access to specialist dermatologists in Australia are well recognised.3 Fortunately, biopsy of the skin is a simple skill to learn which can greatly help with the diagnosis of dermatological diseases. For cutaneous malignancies, the diagnosis is principally based on histopathological findings. However, for rashes, the correlation between clinical and pathological findings is paramount. For instance, observation of a lichenoid reaction pattern on skin biopsy may reflect lichen planus, lupus, dermatomyositis, lichen sclerosus, cutaneous T cell lymphoma, or graft‐versus‐host disease. To maximise the diagnostic yield of a skin biopsy, an understanding of the different types of biopsy, their indications and limitations is vital (Box 1 and Box 2).

  • Kirsty JL Wark1
  • Saxon D Smith2,3
  • Deshan F Sebaratnam1,4

  • 1 Liverpool Hospital, Sydney, NSW
  • 2 Royal North Shore Hospital, Sydney, NSW
  • 3 University of Sydney, Sydney, NSW
  • 4 Sydney Children's Hospitals Network, Sydney, NSW


Series editors

Balakrishnan (Kichu) Nair

Simon O'Connor


We thank Alicia O'Connor, Anes Yang, Victoria Venning, Imogen Faulds and our patients for their contributions to the clinical images.

Competing interests:

No relevant disclosures.


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