Toe Punch Biopsy to Test for Malignant Melanoma | Auburn Medical Group

Toe Punch Biopsy to Test for Malignant Melanoma | Auburn Medical Group

Today, we are going to be doing a punch biopsy. Our patient has given consent to show her on the camera, and you can talk if you want, if you don’t mind people hearing your voice. What we are going to do is look first at the area of interest, which is your toe. And the reason that we were wanting to get a biopsy of this is because it has some features of it that look concerning to me, to possibly be a type of skin cancer. The type of skin cancer that we are concerned about here is Malignant Melanoma. Malignant Melanoma being the kind that is known to spread to other parts of the body. And, this is very serious if it is, so we need to check to find out. I will say that the majority of biopsies I do of this turn out to be just a mole. But, we do need to check it. So we take a look at it here, and the features that i’m noticing are (1) the size. This has not been here all along, right? No, for about 2 years. Two years, and when I measure it, it measures more than 4 millimeters across, and in fact, it’s a good centimeter across, or 11 millimeters I guess it looks like to me. From end to end. The other thing I don’t like is the very dark nature of the color, and the variegated color, or the variation that you see. From the lighter over here, to the darker in here, and down here, and over here at this end. And then the other thing that would come up on a thing like this is the texture of it. Now when I feel it, it’s totally smooth, and that is good. It’s bad to have it rough, and up and down, and various levels to it, what I call a topography for people who know what a topography map is, one that shows the ups and downs. You don’t want topography, so that is a good thing about this. So the 2 points it has for it that make me concerned are the size, relatively fast growth if it’s only been there for 2 years, it hasn’t been there with you all your life. But also, I guess the 3rd point, the color variation, and the darkness of some of the areas. We are going to do a punch biopsy, which is recommended for when you are concerned about Malignant Melanoma. A punch biopsy goes all the way through all of the layers of skin. This is cold. It’s nice because it makes it numb before you actually give the shot, so i’m going to do that first. You feel that, don’t you? Yep. There, you see how that kind of frosts? And then we’ll give you a shot. As the skin fills up with the medicine. Are you still feeling it? A little bit, but it’s okay. Go ahead, and get it done. I’m going to say of the areas, this really dark area here gets my attention, but also this area here, where there is a little black dot with a lot of brown around it. If I was going to choose one that looks the worst, i’d probably say it’s this side right here. Are you feeling anything? Just the pressure. We may get a little bit more blood than we would had I used Epinephrine. Actually not much. You still doing okay? Yeah. Alright. Are you wishing you were somewhere else? Of course. Yeah, with a nice doctor? Who doesn’t do mean things to you? And, that is really the whole procedure. Thanks for joining us, we invite you to share with your friends, to like the video, make sure you are subscribed, and until next time, this is Dr. Mark Vaughan telling all of you to stay in good health!


  1. Has the pathology report come back yet? Is there a diagnosis? Hope the results show a benign growth.

  2. hello doctor
    I have a question I notice a black line on my toe Luke if someone grabbed a marker and did a straight black line on my toe I got it at least 2 months ago but it is getting longer I never dropped and thin on my toe so I am worried I will get my biopsy next week

  3. Dr Mark, since you didn't take the lesion off in your office if it comes back as a cancer will you remove it? If you don't remove it will you refer the pt to a plastic surgeon or dermatologist? I guess either would do a great job on it's removal.

  4. I'm afraid I have a strong evidence that the mole in my foot is a case of melanoma base on what you said Dr. and all the videos about skin cancer, but I don't have the capacity to send my self to a doctor.. :'(

  5. well i watched a few of your videos, but my question is why your not putting the diagnoses on the video to or do a follow up on your videos i seen four videos that had to do autopsy but never no what the answer came back as

  6. Thank you for this video. It made me feel less nervous about getting my abnormal mole checked out. Doctors like you make it easier for us scardy cats to go to the doctor sooner rather than later. 🙂

  7. I recently noticed a yellowish patch of skin inbetween my big toe and the toe next to it. I'm currently 15 and refuse to believe that it's melanoma due to my age and not having a personal or family history but there's the thought in the back of my mind about the "what ifs" any thoughts?

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