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There are anecdotal reports of dogs detecting melanoma and studies of canines being able to not only detect but also distinguish cancer from...
Nail matrix biopsies are performed to confirm a diagnosis or surgically remove a skin lesion that is affecting the growth of the nail plate. The procedure may be used to identify:
- Inflammatory conditions such as nail psoriasis and lichen planus
- Benign tumors
- Solitary melanonychia
- Squamous cell carcinoma (SCC)
- Other nail disorders
Nail biopsy can lead to complications such as bleeding, infection, or scarring. Postoperative scarring can cause permanent nail splitting, dystrophy, or both.
In a Cosmetic Dermatology article, “Matrix Biopsy of Longitudinal Melanonychia and Longitudinal Erythronychia: A Step-by-Step Approach,” Drs. Siobhan C. Collins and Nathaniel J. Jellinek review 6 techniques used to biopsy the nail matrix.
- Punch excision
- Matrix shave
- Lateral longitudinal excision
- Midline/paramedian longitudinal excision
- Transverse excision
- Longitudinal excision of erythronychia
Techniques used to biopsy the nail matrix. From Cosmet Dermatol. 2009;22:130-136.
In the setting of longitudinal melanonychia (to diagnose nail melanoma or SCC) and longitudinal erythronychia (to diagnose SCC and rarely amelanotic melanoma or basal cell carcinoma), the techniques they describe accomplish 3 fundamental goals of nail surgery:
- Obtain adequate tissue via an excisional biopsy to make an accurate diagnosis and avoid sampling error
- Avoid unnecessary trauma to surrounding nail tissues by the judicious use of partial plate avulsions whenever feasible
- Avoid unnecessary postoperative nail scarring whenever possible
Dermatologists must be confident when performing nail biopsies and the techniques discussed by the authors will help approach nail surgery with more certainty.
At the 73rd Annual Meeting of the American Academy of Dermatology, Dr. Jellinek provides a hands-on approach to nail surgery. On Saturday, March 21, he will provide tips for nail surgeries at the “Medical and Surgical Management of Nail Disorders” lecture.
For more information, read the Collins and Jellinek article from Cosmetic Dermatology.