Same HPV lesion case — what type of BIOPSY should be requested?

Correct answer: D. Excisional biopsy

• A. Fluorescence (VELscope) is a screening adjunct — not a biopsy technique itself.
• B. Incisional biopsy removes only a portion of the lesion — appropriate for large lesions or suspected malignancy. For a small papilloma that can be completely excised, excisional biopsy is preferred.
• C. Brush biopsy (OralCDx) samples surface epithelial cells — it does not provide the full-thickness histopathology needed to identify koilocytes and confirm HPV.
• D. For an HPV-induced PAPILLOMA that is small and well-circumscribed, EXCISIONAL BIOPSY (complete removal) is appropriate — it is both diagnostic AND therapeutic. The small size of most oral papillomas makes excisional biopsy practical, as the entire lesion can be removed and submitted for histopathological examination simultaneously.