Nail

A nail case presents varied anatomical structures and tissue types: nail plateNail plate, nail bedNail bed, matrix, proximal and lateral folds, hyponychium, and eponychium. Though composed of many elements, the entire nail apparatusNail apparatus should be conceptualized as a single unit, as rarely is just one isolated component of the nail involved in a Mohs surgery case. The Mohs technician may follow the nail tissue specimen as it is excised in the Mohs surgery room to understand and preserve orientation. The nail tissue may be excised as a single block or in multiple parts by the Mohs surgeon, and the Mohs technician needs to recognize nail anatomy to reconstitute the jigsaw puzzle of margins. Further teamwork at the microscope to troubleshoot any tissue processing issues is invaluable. Given the complexity of multiple tissue planes in the nail unit, close communicationCommunication between the Mohs surgeon and technician is critical during the entire process. The most common tumor of the nail unit is squamous cell carcinoma and is frequently associated with human papilloma virus.