Clinician employed that excluded 5% of the largest and 5% of the smallest biopsy specimens from each study year. The trimmed mean among specimens was compared for statistical significance using a 1-tailed test (P.05) in all 4 study years. Results The Table displays the makeup of all 500 pathology reports and the distribution of these characteristics according to each of the 4 study years. Of the total reports analyzed, 224 (44.80%) were from academic-based dermatologists, and 276 (55.20%) were from dermatologists in private practice. In all, 161 (32.20%) reports were on the punch biopsy method, and 339 (67.80%) were on the shave technique. In 1988, 63.20% of the biopsies analyzed were punch biopsies, whereas in 2003, only 22.40% were of the punch type. Although punch biopsies were preferred in 1988, the trend in 2003 favored Comparison of Skin Biopsies 1988 Biopsies performed by dermatologists in both academic and private practices followed this tendency. The mean size of all punch biopsy specimens analyzed was 3.67 mm, with a mode of 3 mm. There was no significant change in the size of the punch biopsy specimen over the 16-year study period. The trimmed mean of the shave biopsy specimen volume for all 339 shave biopsies analyzed was 37.67 mm3 . The trimmed mean of the biopsies performed by dermatologists in academic and private practices was 35.47 mm3 and 38.33 mm3 , respectively. This difference was not significant. From 1988 until 2003, the trimmed mean of shave biopsy volume declined from 65.00 mm3 to 33.90 mm3 (Figure 2). The difference between the trimmed mean of the shave biopsies performed in 1988 compared with those performed in 1993, 1998, and 2003 was significant (P.05 on all comparisons). Although the size of the biopsy specimens continued to decline each year, there was no significant difference between the trimmed mean of those performed in 1993 and 1998 or in 1998 and 2003. There was no significant difference between the trimmed mean of biopsies performed by dermatologists in academic versus private practices. In each of the 4 study years, biopsy specimens were most frequently taken from the head. There was no statistical significance between the study years regarding the number of biopsies performed for growths versus rashes. Comment Dermatology is an ever-changing field. As the discipline continues to evolve, certain practices will fade and others will grow. We identified a trend of increased use of the shave biopsy technique and decreased biopsy specimen size. Although we did not attempt to identify a cause for this trend, we did speculate about some of the factors that may have influenced the decrease in biopsy specimen size over the 16-year study period. Dermatology is