1345 A Punch Above the Rest: A High Yield Modification of The Diagnostic Nailbed Biopsy

Abstract Aim Diagnostic nailbed biopsy is indicated for pathology including malignancy, persistent and suspected mycomial infection rheumatological disease. Operatively, the challenge resides in establishing an equilibrium between harvesting ample histological sample diagnostic value without creation of a functionally aesthetically unacceptable nail due to significant disruption nailbed. We illustrate simple reproducible technique through one small forgiving defect surrounding soft tissue. Method The procedure carried out under normal sterile conditions with local anaesthetic ring tourniquet. A 5mm punch taken nail, adjacent eponychium, followed by 4mm underlying at 45-degree angle. subungual surface tangentially transected generating sent histology. remaining replaced if not required histology, cyanoacrylate glue applied finger dressing. Results Figures show example how out. Biopsy resulting also displayed. Conclusions double reliably harvests adequate specimens wound, plate, perionychium. This even more priority when histology identifies no requiring further operative resection. Whilst undergoes its growth cycle post-operatively, aesthetically, fingertip does draw undue patient dissatisfaction once dressing removed comparison alternative techniques.