TY - CHAP M1 - Book, Section TI - Nail Surgery A1 - Baran, Robert A1 - Cogrel, Olivier A2 - Kang, Sewon A2 - Amagai, Masayuki A2 - Bruckner, Anna L. A2 - Enk, Alexander H. A2 - Margolis, David J. A2 - McMichael, Amy J. A2 - Orringer, Jeffrey S. Y1 - 2019 N1 - T2 - Fitzpatrick's Dermatology, 9e AB - AT-A-GLANCENail surgery requires careful patient selection to prevent unnecessary complications.The technique used for anesthesia depends on the type of surgery. Distal digital block with ropivacaine 2 mg/mL is usually the best option.Partial nail avulsion allows the exploration and/or the treatment of a subungual lesion or the removal of a pathologic nail plate. Total nail plate avulsion should be discouraged to prevent nail bed shrinking and distal embedding.Nail biopsies are performed to determine the histopathologic features of a lesion or to clarify an uncertain clinical diagnosis.Lateral longitudinal biopsy is the best technique for inflammatory disorders or lateral longitudinal melanonychia.Punch biopsy less than 3 mm in the distal matrix does not produce serious dystrophy.Tangential shave excision is the best option for superficial matrix tumors such as wide longitudinal melanonychia or superficial epithelial benign tumors. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/11 UR - accessmedicine.mhmedical.com/content.aspx?aid=1172926818 ER -