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he dermatologist's technique for sampling skin has remained relatively unchanged over the last 10 years. Exophytic lesions are typically shaven, while deeper processes are sampled with a punch biopsy. However, we have found that these two techniques are often impractical and cumbersome in their application to some cutaneous morphologies.Weintroduceatechniquewhichemploysapunchbiopsy-pen to perform a shave or "scoop" excision.This method is ideally designed for those lesions in which a deep shave is required, but a straight blade is awkward to apply flush with the skin surface. The potential disadvantage of shaving a flat lesion or plaque is the inability to achieve a sufficiently deep or representative sample. Oftentimes, placing a blade flush against the skin's surface and cutting parallel makes it impossible to gain an adequate sample size. Alternatively, if one angles the blade at a 45-degree angle, a jagged or "ripped" sample may result in suboptimal histopathology and healing. The scoop ensures that adequate tissue sampling is achieved, thus making a histopathologic diagnosis readily available. The scoop also results in a smooth biopsy edge which results in less trauma and more rapid healing without scar. The scoop has the additional benefit of providing enough depth so as to make prognostication more accurate in cases of suspected malignancy.1

Surgical Pearl: The Pendulum or "Scoop" Biopsy