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Communication Station 5


You are a junior doctor working in a GP setting. You have two minutes to read the information sheet provided. Using the information, proceed to explain to the patient about their upcoming skin biopsy.
 
What is a skin biopsy and why do I need it?
A skin biopsy is a routine investigation that helps us to diagnose skin conditions. It can also be used as a treatment to remove some abnormalities, such as moles. A biopsy is where a small sample of skin is removed under local anaesthetic in order for it to be looked at under the microscope. Local anaesthetic is a medication that numbs the specific area of the body so it is pain free, but does not put you to sleep. There are no alternatives to this procedure; it is the only way to get the information needed to make a correct diagnosis.
 
Before your biopsy
Please let the staff looking after you know if you are taking any antiplatelet medicines (such as aspirin or clopidogrel) or any anticoagulant medicines (such as warfarin or rivaroxaban) as they may increase the risk of bleeding during and after the procedure.
Please let us know if you have any allergies to medications including local anaesthetic, or if you are planning to travel within two weeks after your biopsy, as this will affect arrangements for removing your stitches (if you have them).
Because some people feel light-headed after their biopsy, you should not drive to your appointment and should have someone to help you home. You can eat, drink as normal before your appointment.
 
Giving my consent (permission)
We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked to sign a consent form. This states that you agree to have the treatment and you understand what it involves.
 
What happens during my skin biopsy?
The biopsy will be performed either by a doctor or a specialist nurse. We will give an injection of local anaesthetic to the area where the biopsy will be taken. This may sting for a few seconds, but then the area will feel numb. You may feel pulling or pressure on the area when we take the biopsy, but it should not be painful. We will take a sample of tissue by cutting or scraping your skin. We may have to take more than one biopsy, depending on your circumstances. If we close your wound(s) with stitches, you will need to have these removed at your GP surgery. The whole procedure is usually completed within 30 minutes.
 
What happens after the procedure?
A nurse will dress your wound and explain how to look after it at home. Please make sure you receive a separate aftercare information sheet before you leave hospital. If you have stitches, your nurse will also discuss arrangements for their removal and will give you a letter to give to the nurse at your GP practice. You will be able to leave hospital as soon as you feel well enough, and can eat and drink as soon as you wish.
 
Will I have any pain or discomfort?
The local anaesthetic will begin to wear off about 30 to 40 minutes after the operation. If you experience any discomfort from your wound, you can take simple painkillers such as paracetamol to help with this.
 
What are the risks?
We will discuss the risks with you in detail before we ask you to sign the consent form. Short-term risks include infection, bleeding and swelling of your wound. Although the biopsies taken are not large, you will have a small scar in the long term.
 
(Adapted from: https://www.guysandstthomas.nhs.uk/resources/patient-information/dermatology/skin-biopsy.pdf)
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