RT Book, Section 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. SR Print(0) ID 1172926818 T1 Nail Surgery T2 Fitzpatrick's Dermatology, 9e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9780071837798 LK accessmedicine.mhmedical.com/content.aspx?aid=1172926818 RD 2024/10/04 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.