Keloid

A type of scar that is made of type I and III collagen, a keloid rises over the site of a wound. Keloids are benign tumors that can develop beyond the area of the original wound. The have a rubbery yet firm appearance and are red, pink or dark brown in color. Keloids have an irregular shape and tend to enlarge progressively. They generally have a dome shape. Unlike scars, keloids do not subside over time. Keloids often are itchy and have a sharp pain, they can restrict movements if they are located over a joint. Any skin injury such as an abrasion, cosmetic piercing, burns, surgery etc can cause keloid.

The exact cause for keloid is not known. Keloids are common in men and women; they might not occur as much in children. Keloids develop more often on the chest, shoulder, back and ear lobes. Keloids can be treated with topical applications, laser treatment, silicone sheets, surgery, radiation, etc. Some keloids are treated with steroid injections or application of steroid-implanted tape to affected areas. Surgery may be performed to remove the keloid but it might not prevent it from growing back again.

Skin Biopsy

A biopsy of the skin is done to clear what is the condition of the skin such as psoriasis, to diagnose a disease such as skin cancer and to diagnose any bacterial or fungal skin infection. A skin biopsy is routinely done in a doctor's clinic as an outpatient procedure. You have to inform the doctor if you suffer any allergies to medications, especially any adverse reactions to local anesthetics or to iodine cleaning solutions. Keep the doctor informed if you are under any medication, are pregnant or suffer bleeding problems.

Skin biopsy procedures

If it is an excision biopsy, the entire suspect skin is cut out. Excision is normally done with a scalpel and the incision is closed up by stitches. If it is a punch biopsy, a sharp cutter is used to remove a small cylinder of skin. Stitches are made to close this type of biopsy wound as well. Such punch biopsies are quick, convenient and done for small wound. A pathologist can get a full thickness view of the skin. Sometimes more than one punch biopsy is necessary. The punch biopsy blade takes a small round core of tissue ranging from 2-6mm dia although 3-4mm is the usual size.

In a shave biopsy, the outermost part of a lesion is shaved off with a scalpel. Only if the top layer of the skin is suspected, a shave biopsy is adopted. A dermatologist will take a superficial slice of skin from the area of affected with a scalpel, dermablade or a razor blade. Although there are no stitches required, there will be a small scar that should heal in about a week's time. An aspiration is used to remove the skin that is fluid filled and not solid. The doctor inserts a small needle attached to a syringe into the lesion and the fluid is sucked out.

The biopsy site is cleaned with an iodine type solution with alcohol and with a sterile soap solution. A sterile towel is placed around the area once the skin is cleaned. A local anesthetic is injected into the skin to make it numb. You may feel a brief prick and stinging sensation as the medicine is injected. The doctor can perform the biopsy once the skin is numb. Now the tissue is removed and sent to the laboratory for analysis by a pathologist. If needed, the wound is stitched up.

A bandage is wound over the biopsy site. You may also be advised to wash the wound and apply antibacterial ointment and change the bandage daily. If you experience any pain in the biopsy site, consult the doctor about medication to relieve it.

• Unexpected bleeding may occur; especially if you are on any blood thinning medications such as aspirin. For instance, arterial puncture on the forehead or temple may take time to stop bleeding.
  
  
• There could be wound infections in about 1-5% of surgeries. There could be ulcerated or crusted skin wounds. Antibiotics may be used to clear this up.
  
  
• Infection is also common in diabetics, elderly patients and those on immunosuppressive medicines.
  
  
• If large scars, called keloids, there is an increased chance of forming a scar over the biopsy site.