Punch Type Skin Biopsy

A skin biopsy is a method we use to take a sample of skin for examination and testing. A skin biopsy can help diagnose a variety of neurological disorders. You can stay with your child during the whole procedure. It will last about 30 minutes. 

• Read this information and then talk about it with your child. Tell your child how and where the procedure will be done. Tell your child what it might feel like and answer your child’s questions. 
• Encourage your child to bring something comforting from home, such as a favorite toy, blanket or pacifier. 
• lf the procedure is scheduled after a meal, make sure your child doesn’t eat too much. Your child doesn’t need to eat a special diet beforehand. 

• At least 30 minutes before the procedure, we  may use a special cream on the biopsy site. This cream numbs the skin so your child won’t feel any pain. 
• The doctor will explain the procedure and ask for your written permission to do the biopsy and testing. 
• Your child will lie down on the examination table, on the side or tummy. We’ll use blankets to make your child as warm and comfortable as possible 
• A child life specialist might help distract your child during the procedure. 
• The doctor will choose an area on your child’s body for the biopsy. Usually it’s just above the elbow or on the back near the shoulder blade. 
• The doctor will use a very small needle to inject the area with lidocaine (numbing medicine). The injection will create a slightly raised area called a “bleb.” 
• There might be a few seconds of discomfort when the lidocaine is injected. The discomfort your child feels is less when numbing cream is used. 
• The doctor will clean skin with iodine swabs and alcohol wipes. Because iodine might interfere with the test, it will then be washed off. 
• The doctor will put on sterile gloves and cover the area with sterile towels to keep the area as clean as possible and lessen the chance of infection. 
• The doctor will use a skin biopsy tool, which looks like a small pencil without an eraser, to remove a small circle-shaped piece of skin where the lidocaine was injected. This should not hurt. 
• The skin sample is then put in a special solution called “medium” that helps skin cells grow. 

After the biopsy, we apply gauze and pressure to limit bleeding. In addition, we wash off the remaining iodine with sterile water. We’ll apply a small amount of antibiotic ointment to the site and put on a bandage. 

Your child will be able to eat, drink and be as active as usual after the procedure.

Keep the biopsy site clean and dry for 48 hours (2 days). Tub baths or swimming are not allowed. 

Change the bandage every day for 2 days, following these instructions. 

• Wash your hands well with soap and water and use an alcohol hand sanitizer. 
• Remove the old bandage. Look at the wound and at the drainage on the old bandage. 
• Wash your hands again. 
• Gently clean the wound with antibacterial soap and water. Clean using a circular (round and round) motion. Pat the area dry after cleaning. 
• Check for signs of infection. 
• After cleaning, apply a small amount of antibiotic ointment and put on an adhesive bandage (Usually a Band-Aid is enough.)

After two days, take off the bandage. Leaving the wound open to the air will help it heal. Continue cleaning the site to reduce the risk of infection. 

The scab might itch while it’s healing. To prevent infection and reduce scarring, try to keep your child from scratching it. Putting gloves, mitts or socks on your child’s hands might help. If you need to, cover the scab during the day and leave it open to air at night. 

A small scar might form at the site of the skin biopsy. For about a year after the wound heals, apply sunscreen and cover the area with a Band-Aid when your child is in the sun to keep the scar from becoming dark. 

It can take months to get the results of some tests. The doctor will discuss the time line and results with you.  

Call if you see any of the following signs of infection. 

• Increasing redness or swelling 
• Red streaks coming from the wound =More pain 
• A bad smell from the wound 
• Pus or other drainage from wound 
• Fever higher than 101 Q F (38.3Q C)  

If you have specific questions about why your child is being tested, ask your child’s doctor.