Nail Biopsy

Nail Biopsy

What is nail biopsy?

A biopsy of the nail is done to help diagnose nail disorders, especially if skin cancer is suspected. It involves taking a small piece of tissue from the nail bed or nail matrix (the part where the nail grows from) for examination under the microscope (histopathological examination).

How is a nail biopsy done?

Local anaesthesia is given through an injection to the finger or toe. The exact nature of the procedure depends on the part of the nail involved.
  • Nail avulsion – This involves removing a part of or the entire nail plate.
  • Nail bed biopsy – This is usually done to diagnose a tumour in the nail bed. The nail is lifted up and the underlying tissue will be removed.
  • Nail matrix biopsy – This is usually done to diagnose a tumour in the nail matrix, such as when the nail is deformed or darkened. The nail and proximal nail fold are lifted to collect the underlying tissue. Stitches may be required to secure the nail fold back in place after the procedure. The nail may also be stitched back in place, allowing it to act as a natural dressing during wound healing.

Why do I need a nail biopsy?

Many conditions can be diagnosed through a nail biopsy. The most common reason for a nail biopsy is to check if the nail condition is due to skin cancer. Here are some conditions that can be diagnosed through a nail biopsy.
  • Fungal nail infections
  • Causes of darkening or pigmentation of the nail
  • Causes of nail deformities
  • Tumours, which may be benign or malignant
  • Other inflammatory disorders, such as lichen planus or psoriasis

What are the risks of nail biopsy?

Nail biopsy is a very safe procedure with low risk. Nonetheless, there are a few things to watch out for.
Bleeding at the site of surgery
Bleeding occurs very commonly after nail biopsy. It is usually minor and stops with compression at the biopsy site.
Pain
The nail biopsy is usually carried out under local anaesthesia. The anaesthetic usually lasts for 1 to 2 hours. If necessary, oral painkillers, such as paracetamol, can also be taken.
Infection at the wound site
The risk of infection is low. Topical antiseptic or antibiotic ointments are usually prescribed to reduce the risk of infection. Sometimes, oral antibiotics may also be given to patients at higher risk of infection.
Scarring
You may have a scar after the surgery. Scars will improve over time.
Changes in the appearance of the nail
Although nail biopsy is a diagnostic procedure, the underlying condition sometimes may improve after the biopsy. However, this does not always happen, depending on the underlying cause of nail abnormality. Nail abnormality can also There be residual pigmentation of the nail plate and permanent nail abnormalities.
Nerve damage
Although your surgeon will try to avoid this, nerves can occasionally be damaged during surgery, leading to a numb area of skin. This is usually temporary.

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The information written and published on this website is not intended to substitute the recommendations of a trained professional and does not replace a professional consultation.
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