Perfect biopsy methods for the diagnosis of malignant melanocytic skin neoplasms (a literature review)

Abstract

Skin biopsy has long been the main method of diagnosing malignant skin neoplasms, particularly melanoma. The modern scientific research is devoted to the actual problem of the clinical dermato-oncology – the search for the most optimal methods of morphological verification of the malignant skin tumors. The problem of the determining safe and effective melanoma biopsy methods in the context of the evidence-based medicine remains particularly relevant. The most popular methods today are excisional and incisional biopsy, shave biopsy and punch biopsy. The most guidelines recommend full-thickness excisional biopsy as the preferred procedure for suspected melanoma, but there are increasing cases where excisional biopsy is not possible. There is currently no consensus on the best technique for skin biopsy in the diagnosis of melanoma. Most publications concluded that misdiagnosis of sufficient depth and thickness of melanoma is likely to lead to inadequate therapy, but the main danger lies in misdiagnosis. Excisional biopsy remains the best and most reliable way to obtain information about skin lesions. The advantage in the choice of the method, in the presence of neoplasms in cosmetically sensitive areas or their large size, is inclined to incisional biopsy. Other techniques, such as punch biopsy or shave biopsy, are recognized as more dangerous in terms of diagnostic inaccuracy, but at the same time do not contribute to the spread of the tumor. The experience of doctors and the choice of medical institution did not have any influence on the choice of methodology and the quality of diagnosis, however, timely consultation of a dermatologist proved to be more rational for timely diagnosis and further treatment. The correct choice of the biopsy method, its technique (depth and edges of excision) for the diagnosis of malignant neoplasms of the skin require further clarification.