Biopsy of the nail bed with removal of the nail plate: Nail Avulsion

This is a patient of Dr Jeff Rebish, who is a board certified dermatologist, my colleague, and my husband. 🙂

Dr Rebish is usually the one who does the nail biopsies. Well, actually, not usually, but ALWAYS. He’s the only one in our office who does nail biopsies, because I don’t do them. I don’t like them, I don’t like doing them, so thank goodness I can send any patient of mine who has an issue like this to him! In exchange, he sends me anything I can pop out of the skin and that’s just fine with me!

This is a patient of his who has a growth under his nail, in his nail bed. This growth is trapped under his nail, but is growing and is causing pain. There are two ways to biopsy a growth under the nail. One way is to do a punch biopsy, essentially taking a core of nail and the tissue underneath. The other is to remove the entire nail, which is what Dr Rebish opted to do in this case, because he couldn’t evaluate what the lesion looked like growing underneath. First, of course, Dr Rebish did a digital nerve block, essentially numbing up the entire area so he can remove the nail without any pain or discomfort.
When he removed the nail, the mass growing underneath, was soft and friable. He thinks it may be a glomus tumor (a benign growth), but it could be malignant. We will find out the biopsy results very soon, and I’ll add the result to this description when I receive it.

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