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Nail Bed Biopsies


- Discussion:
    - indicated for the diagnosis of nail tumors or unexplained deformities;
    - may be performed using "punch method" or thru open nail bed biopsy;
    - open biopsies should use transverse incisions in the nail matrix and longitudinal incisions in the nail bed;
    - biopsy material should not be handled directly, but rather should be removed with a needle;

- Nail Matrix Biopsy:
    - if possible avoid biopsy thru the nail matrix, and especially avoid biopsy of the more proximal matrix (as this contributes to the surface of 
         the nail);
    - biopsy is indicated for pigemented longitudinal streaks (which are suspicious for melanoma;
         - in this case mark the proximal nail fold to assist w/ locating the pathologic matrix (after the nail is removed);
    - open biopsies should use transverse incisions in the nail matrix and longitudinal incisions in the nail bed