The anesthesia can be administered using a true digital block, which involves injecting the anesthetic agent into the lateral base of the digit, or through a wing block, whereby the agent is injected into the proximal nail fold. "In my experience, a wing block is quicker, and because it requires a smaller volume of anesthesia, it is safer," said Dr. Rich. "It is also much less painful than a digital block."
Dr. Rich has received advisory board honoraria from Abbott Laboratories and investigator grants from Centocor Inc., Wyeth, and Genentech Inc.
Subungual melanoma often presents initially as longitudinal melanonychia.
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