Nail biopsy techniques
Keywords:
Nail diseases, biopsy, techniques.Abstract
The nail biopsy is an invaluable tool for the diagnosis of different diseases that affect the nail unit, but its use is not frequent due to the ignorance of the techniques, the lack of experience by the specialists or the fear of its sequels or after-effects. The success of this procedure depends on the precise identification of the nail area that must be taken for the biopsy, the appropriate selection of the type of biopsy for each case, the accurate control of the surgical technique to obtain representative and adequate samples, and its cautious sending to the dermopathologist who will study the specimen. The failure of this procedure can mean a catastrophic outcome for the patients. Objective: To illustrate the adequate way to take a nail biopsy. In the daily practice we see that it is not being done appropriately, delaying the diagnosis of critical conditions such as melanoma.
Author Biographies
Alvaro Acosta
Coordinador Dermatología, Instituto Nacional de Cancerología, Profesor Asociado Universidad Nacional de Colombia
Marian Rolón
Dermatóloga, Patóloga Oncóloga, Instituto Nacional de Cancerología, Fundación Santa Fe de Bogotá.
Catalina Muñoz
Fellow Cirugía Plástica Oncológica, Universidad Militar - Instituto Nacional de Cancerología.
References
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2. Rich P. Nail biopsy: Indications and methods. Dermatol Surg. 2001;27:229-34.
3. Kovich O, Soldano A. Clinical pathologic correlations for diagnosis and treatment of nail disorders. Dermatologic Therapy. 2007;20:11-6.
4. Grover C, Nanda S, Reddy BS, Chaturvedi KU. Nail biopsy: Assessment of indications and outcome. Dermatol Surg. 2005;31:190-4.
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6. Grover C, Chaturvedi UK, Reddy BS. Role of nail biopsy as a diagnostic tool. Indian J Dermatol Veneorol Leprol. 2007;78:290-8.
7. Zook E. Preoperative and postoperative management. En: Krull E, Zook E, Baran R, Haneke E. Nail surgery: A text and atlas. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 29-33.
8. Wong K, Huq N, Nakhooda A. Hand surgery using local anesthesia. Clin Plast Surg. 2013;40:567-81.
9. Williams J, Lalonde D. Randomized comparison of the single-injection volar subcutaneous block and the two-injection dorsal block for digital anesthesia. Plast Reconstr Surg. 2006;118:1195-200.
10. Harbinson S. Transthecal digital block: Flexor tendon sheath used for anesthetic infusion. J Hand Surg. 1991;16A:957.
11. Low C, Vartany A, Engstrom J, Poncelet A, Diao E. Comparison of transthecal and subcutaneous single-injection digital block techniques. J Hand Surg. 1997;22A:901-5.
12. Cummings A, Tisol W, Meyer L. Modified transthecal digital block versus traditional digital block for anesthesia of the finger. J Hand Surg Am. 2004;29:44-52.
13. Keramidas E, Rodopoulou A, Tsoutsos D, Miller G, Iovannovich J. Comparison of transthecal digital block and traditional digital block for anesthesia of the finger. Plast Reconst Surg. 2004;114:1131-4.
14. Kollersbeck C, Walcher T, Gradi G, Genelein F. Clinical experience and dosage pattern in subcutaneous single-injection digital block technique. Handchir Mikrochir Plast Chir. 2004;36:64-6.
15. Chowdhry S, Seidenstricker L, Cooney D, Hazany R, Wilhelmi B. Do not use epinephrine in digital blocks: Myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010;126:2031-4.
16. Fisher L, Gordon M. Anesthesia for hand surgery. En: Wolfe S, Hotchkiss R, Pederson W, Kozin S. Operative hand surgery. 6th edition. Philadelphia: Elsevier, Churchill Livingstone; 2011. p. 32-3.
17. Jellinek N. Nail surgery: Practical tips and treatment options. Dermatol Ther. 2007;20:68-74.
18. Fitzcharles-Bowe C, Denkler K, Lalonde D. Finger injection with high-dose epinephrine: Does it cause finger necrosis and should it be treated? Hand. 2007;2:5-11.
19. Lalonde D, Bell M, Benoit P, Sparkles G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: The Dalhousie Project clinical phase. J Hand Surg. 2005;30A:1061-7.
20. Wilhelmi B, Blackwell S, Miller J, Mancoli J, Dardano T, Tran A, et al. Do not use epinephrine in digital blocks: Myth or truth? Plast Reconstr Surg. 2001;107:393-400.
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23. Haneke E. Nail surgery. Clin Dermatol. 2013;31:516-525
24. Di Chiacchio, Ruben B, Refkalevsky W. Longitudinal melanonychias. Clin Dermatol. 2013;31:594-601
25. Barrera M, Tejera A, Mendiola M, Cabra J, Herrera E. Diagnostic utility of nail biopsy: A study of 15 cases. Actas Dermosifiliogr. 2008;99:621-7.
26. Baran R, Berker D, Dawber R. Nail unit tumours and surgery. En: Baran R, Berker D, Dawber R.¿Editores? Manual of nail disease and surgery: New Jersey:Blackwell Science Ltd.; 1997. p. 53-88. Incompleto
27. Braun RP, Baran R, Le Gal FA, Dalle S, Ronger S, Pandolfi R, et al. Diagnosis and management of nail pigmentations. J Am Acad Dermatol. 2007;56:835-47.
28. Berker D. Lateral longitudinal nail biopsy. Australas J Dermatol. 2001;42:142-4.
29. Jellinek N. Nail matrix biopsy of longitudinal melanonychia: Diagnostic algorithm including the matrix shave biopsy. J Am Acad Dermatol. 2007;56:803-10.
30. Di Chiacchio N, Refkalefsky L, Schwery N, Veiga F. Tangential biopsy thickness versus depth in longitudinal melanonychia: A pilot study. Dermat Res Pract. 2012:353864.
31. Geisse JK. Biopsy techniques for pigmented lesions of the skin. Pathology (Phila). 1994;2(2):181-93.
32. Collins S, Cordova K, Jellinek N. Alternatives to complete nail plate avulsion. J Am Acad Dermat. 2008;59:619-26.
33. Krull E. Biopsy techniques. En: Krull E, Zook E, Baran R, Haneke E. Nail surgery: A text and atlas. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 55-81.
34. Martínez W, Restrepo R. Procesamiento de biopsias de piel en el laboratorio de patología. Rev Asoc Col Dermatol. 2014;22:39-55.
35. Campbell S, Rubin A. Update: Nail unit dermatopathology. Dermatol Ther. 2012;25:551-68.
36. Acosta A, Fierro E, Velásquez V, Rueda X. Melanoma: patogénesis, clínica e histopatología. Rev Asoc Col Dermatol. 2009;17:87-108.
37. Collins S, Cordova K, Jellinek N, Midline/paramedian longitudinal matrix excision with flap reconstruction: Alternative surgical techniques for evaluation of longitudinal melanonychia. J Am Acad Dermatol. 2010;62:627-36.
38. Silverstein D, Mariwall K. Biopsy of the pigmented lesions. Dermatol Clin. 2012;30:435-43.
39. Pozzobon F, Acosta A, Carreño A, Fierro E. Características del melanoma cutáneo primario en el Instituto Nacional de Cancerología, 2006-2010. Rev Asoc Col Dermatol. 2013;17:111-9.
40. Drake L, Dinehart S, Farmer E, Goltz R, Graham G, Hordinsky M, et al. Guidelines of care for superficial mycotic infections of the skin: Onychomycosis. J Am Acad Dermat. 1996;34:116-21.
41. Weinberg J, Koestenblatt E, Tutrone W, Tshler H, Najarian l. Comparison of diagnostic methods in the evaluation of onychomycosis. J Am Acad Dermatol. 2003;49:193-200.
42. Panasiti V, Borroni R, Devirgiliis V, Rossi M, Fabrizzio L, Masciangelo R, et al. Comparison of diagnostic methods in the diagnosis of dermatomycosis and onychomycoses. Mycoses. 2006;49:26-35.
43. Pierard G, Arrese J, De Doncker D, Franchimonto C. Present and potential diagnosis techniques in onychomycosis. J Am Acad Dermatol. 1996;34:273-80.
44. Gianni C, Morelli V, Cerri A, Greco C, Rossini P, Guiducci A, et al. Usefulness of histological examination for the diagnosis of onychomycosis. Dermatology. 2001;202:283-92.
45. Gómez L, Massaro M, Tabares A, Zuluaga A, Vélez J, Vélez A, et al. Utilidad de la muestra de la lámina ungular en el diagnóstico de onicomicosis. Rev Asoc Colomb Dermatol. 2011;19:194-200.
46. Haghani I, Shokohi T, Hajheidari Z, Khalilian A, Aghili S. Comparison of diagnostic methods in the evaluation of onychomycosis. Mycopathologia. 2013;175:315-21.
47. Grammar-West N, Corvette D, Giandonis M, Fitzpatrick J. Clinical pearl: Nail plate biopsy for the diagnosis of psoriatic nails. J Am Acad Dermatol. 1998;38:260-2.
48. Berker D, Baran R. Acquired malalignment: A complication of lateral longitudinal nail biopsy. Acta Derm Venereol. 1998;78:468-70.
2. Rich P. Nail biopsy: Indications and methods. Dermatol Surg. 2001;27:229-34.
3. Kovich O, Soldano A. Clinical pathologic correlations for diagnosis and treatment of nail disorders. Dermatologic Therapy. 2007;20:11-6.
4. Grover C, Nanda S, Reddy BS, Chaturvedi KU. Nail biopsy: Assessment of indications and outcome. Dermatol Surg. 2005;31:190-4.
5. Tosti A, Piraccini B. Biology of nails and nail disorders. En: Goldsmith L, Katz S, Gilchrest B, Paller A, Leffell D, Wolff K. Fitzpatrick´s dermatology in general medicine. 8th edition. New York: McGraw Hill; 2012. p. 1009-30.
6. Grover C, Chaturvedi UK, Reddy BS. Role of nail biopsy as a diagnostic tool. Indian J Dermatol Veneorol Leprol. 2007;78:290-8.
7. Zook E. Preoperative and postoperative management. En: Krull E, Zook E, Baran R, Haneke E. Nail surgery: A text and atlas. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 29-33.
8. Wong K, Huq N, Nakhooda A. Hand surgery using local anesthesia. Clin Plast Surg. 2013;40:567-81.
9. Williams J, Lalonde D. Randomized comparison of the single-injection volar subcutaneous block and the two-injection dorsal block for digital anesthesia. Plast Reconstr Surg. 2006;118:1195-200.
10. Harbinson S. Transthecal digital block: Flexor tendon sheath used for anesthetic infusion. J Hand Surg. 1991;16A:957.
11. Low C, Vartany A, Engstrom J, Poncelet A, Diao E. Comparison of transthecal and subcutaneous single-injection digital block techniques. J Hand Surg. 1997;22A:901-5.
12. Cummings A, Tisol W, Meyer L. Modified transthecal digital block versus traditional digital block for anesthesia of the finger. J Hand Surg Am. 2004;29:44-52.
13. Keramidas E, Rodopoulou A, Tsoutsos D, Miller G, Iovannovich J. Comparison of transthecal digital block and traditional digital block for anesthesia of the finger. Plast Reconst Surg. 2004;114:1131-4.
14. Kollersbeck C, Walcher T, Gradi G, Genelein F. Clinical experience and dosage pattern in subcutaneous single-injection digital block technique. Handchir Mikrochir Plast Chir. 2004;36:64-6.
15. Chowdhry S, Seidenstricker L, Cooney D, Hazany R, Wilhelmi B. Do not use epinephrine in digital blocks: Myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010;126:2031-4.
16. Fisher L, Gordon M. Anesthesia for hand surgery. En: Wolfe S, Hotchkiss R, Pederson W, Kozin S. Operative hand surgery. 6th edition. Philadelphia: Elsevier, Churchill Livingstone; 2011. p. 32-3.
17. Jellinek N. Nail surgery: Practical tips and treatment options. Dermatol Ther. 2007;20:68-74.
18. Fitzcharles-Bowe C, Denkler K, Lalonde D. Finger injection with high-dose epinephrine: Does it cause finger necrosis and should it be treated? Hand. 2007;2:5-11.
19. Lalonde D, Bell M, Benoit P, Sparkles G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: The Dalhousie Project clinical phase. J Hand Surg. 2005;30A:1061-7.
20. Wilhelmi B, Blackwell S, Miller J, Mancoli J, Dardano T, Tran A, et al. Do not use epinephrine in digital blocks: Myth or truth? Plast Reconstr Surg. 2001;107:393-400.
21. Huang C. Regional anesthesia. En: Harahap M, Abadir A. Anesthesia and analgesia in dermatologic surgery. New York: CRC Press; 2008. p. 102-3.
22. Montes A, Gómez L, Londoño A, Arias Y, Martínez E. Evaluación de una técnica quirúrgica para el tratamiento de la onicocriptosis en pacientes atendidos en la Clínica Universitaria Bolivariana y Clínica Soma, de enero de 1998 a diciembre de 2010. Rev Asoc Colomb Dermatol. 2012;20:322-9.
23. Haneke E. Nail surgery. Clin Dermatol. 2013;31:516-525
24. Di Chiacchio, Ruben B, Refkalevsky W. Longitudinal melanonychias. Clin Dermatol. 2013;31:594-601
25. Barrera M, Tejera A, Mendiola M, Cabra J, Herrera E. Diagnostic utility of nail biopsy: A study of 15 cases. Actas Dermosifiliogr. 2008;99:621-7.
26. Baran R, Berker D, Dawber R. Nail unit tumours and surgery. En: Baran R, Berker D, Dawber R.¿Editores? Manual of nail disease and surgery: New Jersey:Blackwell Science Ltd.; 1997. p. 53-88. Incompleto
27. Braun RP, Baran R, Le Gal FA, Dalle S, Ronger S, Pandolfi R, et al. Diagnosis and management of nail pigmentations. J Am Acad Dermatol. 2007;56:835-47.
28. Berker D. Lateral longitudinal nail biopsy. Australas J Dermatol. 2001;42:142-4.
29. Jellinek N. Nail matrix biopsy of longitudinal melanonychia: Diagnostic algorithm including the matrix shave biopsy. J Am Acad Dermatol. 2007;56:803-10.
30. Di Chiacchio N, Refkalefsky L, Schwery N, Veiga F. Tangential biopsy thickness versus depth in longitudinal melanonychia: A pilot study. Dermat Res Pract. 2012:353864.
31. Geisse JK. Biopsy techniques for pigmented lesions of the skin. Pathology (Phila). 1994;2(2):181-93.
32. Collins S, Cordova K, Jellinek N. Alternatives to complete nail plate avulsion. J Am Acad Dermat. 2008;59:619-26.
33. Krull E. Biopsy techniques. En: Krull E, Zook E, Baran R, Haneke E. Nail surgery: A text and atlas. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 55-81.
34. Martínez W, Restrepo R. Procesamiento de biopsias de piel en el laboratorio de patología. Rev Asoc Col Dermatol. 2014;22:39-55.
35. Campbell S, Rubin A. Update: Nail unit dermatopathology. Dermatol Ther. 2012;25:551-68.
36. Acosta A, Fierro E, Velásquez V, Rueda X. Melanoma: patogénesis, clínica e histopatología. Rev Asoc Col Dermatol. 2009;17:87-108.
37. Collins S, Cordova K, Jellinek N, Midline/paramedian longitudinal matrix excision with flap reconstruction: Alternative surgical techniques for evaluation of longitudinal melanonychia. J Am Acad Dermatol. 2010;62:627-36.
38. Silverstein D, Mariwall K. Biopsy of the pigmented lesions. Dermatol Clin. 2012;30:435-43.
39. Pozzobon F, Acosta A, Carreño A, Fierro E. Características del melanoma cutáneo primario en el Instituto Nacional de Cancerología, 2006-2010. Rev Asoc Col Dermatol. 2013;17:111-9.
40. Drake L, Dinehart S, Farmer E, Goltz R, Graham G, Hordinsky M, et al. Guidelines of care for superficial mycotic infections of the skin: Onychomycosis. J Am Acad Dermat. 1996;34:116-21.
41. Weinberg J, Koestenblatt E, Tutrone W, Tshler H, Najarian l. Comparison of diagnostic methods in the evaluation of onychomycosis. J Am Acad Dermatol. 2003;49:193-200.
42. Panasiti V, Borroni R, Devirgiliis V, Rossi M, Fabrizzio L, Masciangelo R, et al. Comparison of diagnostic methods in the diagnosis of dermatomycosis and onychomycoses. Mycoses. 2006;49:26-35.
43. Pierard G, Arrese J, De Doncker D, Franchimonto C. Present and potential diagnosis techniques in onychomycosis. J Am Acad Dermatol. 1996;34:273-80.
44. Gianni C, Morelli V, Cerri A, Greco C, Rossini P, Guiducci A, et al. Usefulness of histological examination for the diagnosis of onychomycosis. Dermatology. 2001;202:283-92.
45. Gómez L, Massaro M, Tabares A, Zuluaga A, Vélez J, Vélez A, et al. Utilidad de la muestra de la lámina ungular en el diagnóstico de onicomicosis. Rev Asoc Colomb Dermatol. 2011;19:194-200.
46. Haghani I, Shokohi T, Hajheidari Z, Khalilian A, Aghili S. Comparison of diagnostic methods in the evaluation of onychomycosis. Mycopathologia. 2013;175:315-21.
47. Grammar-West N, Corvette D, Giandonis M, Fitzpatrick J. Clinical pearl: Nail plate biopsy for the diagnosis of psoriatic nails. J Am Acad Dermatol. 1998;38:260-2.
48. Berker D, Baran R. Acquired malalignment: A complication of lateral longitudinal nail biopsy. Acta Derm Venereol. 1998;78:468-70.
How to Cite
1.
Acosta A, Rolón M, Muñoz C. Nail biopsy techniques. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2019 Aug. 9 [cited 2024 Jul. 3];23(1):49-60. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/1066
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Published
2019-08-09
How to Cite
1.
Acosta A, Rolón M, Muñoz C. Nail biopsy techniques. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2019 Aug. 9 [cited 2024 Jul. 3];23(1):49-60. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/1066
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