What are the key indications for performing a skin biopsy in primary care?

Key indications for performing a skin biopsy in primary care include:

• Suspicion of melanoma or other skin cancers, particularly when a lesion shows asymmetry, border irregularity, colour variation, diameter enlargement, or evolving characteristics, warranting histological confirmation ¹.
• Uncertain diagnosis of atypical or persistent skin lesions that do not respond to initial treatment or have unusual features, to establish a definitive diagnosis and guide management ¹.
• Lesions suspected to be inflammatory or infectious dermatoses where clinical examination alone is insufficient to differentiate between conditions, and biopsy can clarify diagnosis (Alguire and Mathes, 1998).
• Evaluation of chronic or progressive skin conditions where malignancy or other serious pathology cannot be excluded clinically, necessitating tissue diagnosis ¹.
• When referral to secondary care is delayed or not immediately available, performing a biopsy in primary care can expedite diagnosis and treatment decisions (Alguire and Mathes, 1998).

Overall, the decision to biopsy in primary care should be guided by clinical suspicion of malignancy, diagnostic uncertainty, and the potential impact on patient management, balancing the need for timely diagnosis with procedural expertise and resources ¹ (Alguire and Mathes, 1998).