Which lesion is a contraindication for shave biopsy?

• A. Hyperpigmented mole greater than 1 cm
• B. Small pimple
• C. Flat mole less than 2 mm
• D. Scar tissue

Answer: (A)

Shave biopsy should not be used when the lesion might be melanoma or when depth and full-thickness information are essential for diagnosis and staging. A hyperpigmented mole larger than 1 cm fits this concern because it carries a higher risk of melanoma; shaving off only the surface can miss deeper invasion, compromise proper histologic assessment (like Breslow depth), and hinder proper treatment decisions. Excisional biopsy with complete removal and small margins is preferred in such cases to ensure the entire lesion is evaluated.

The other scenarios describe lesions that are typically benign or superficially located and do not require full-thickness sampling, so a shave biopsy is generally acceptable there.