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  Indian J Med Microbiol
 

Figure 11: (a-g) Nail matrix biopsy for a case with longitudinal pigmented band with spread of pigment in the proximal nail fold (Hutchinson's sign). (a) Separation of the proximal nail fold from the nail plate. (b) Lateral release incisions to enable retraction of the proximal nail fold. (c) Lateral release incision on the other side. (d) Proximal partial avulsion of the nail plate with a nail spatula. (e) Separation of the proximally avulsed nail plate with nail splitter. (f) Exposed origin of the pigmented band which is then tangentially excised. (g) The proximal nail fold is then allowed to fall back and sutured in place. The avulsed nail plate can be replaced temporarily after trimming its margins

Figure 11: (a-g) Nail matrix biopsy for a case with longitudinal pigmented band with spread of pigment in the proximal nail fold (Hutchinson's sign). (a) Separation of the proximal nail fold from the nail plate. (b) Lateral release incisions to enable retraction of the proximal nail fold. (c) Lateral release incision on the other side. (d) Proximal partial avulsion of the nail plate with a nail spatula. (e) Separation of the proximally avulsed nail plate with nail splitter. (f) Exposed origin of the pigmented band which is then tangentially excised. (g) The proximal nail fold is then allowed to fall back and sutured in place. The avulsed nail plate can be replaced temporarily after trimming its margins