Abstract 14

Archives of Dermatology, 128:331-332, 1992.

Local Anesthesia Obtained via Iontophoresis as an Aid to Shave Biopsy

J. Mich'l Maloney, MD
Cherry Creek Dermatology, Private Practice, Denver, Colorado

A 13-year old white girl presented with a slowly growing lesion on the tip of her nose. She denied any personal or family history of skin cancer, blistering sunburns in childhood, or health problems. Findings from the physical examination showed few nevi over the upper aspect of the trunk and extremities. A 4 mm dome-shaped, evenly hyperpigmented lesion was present on the tip of her nose. The working diagnosis was ?benign dermal nevus. A galvanic current was use to drive the lidocaine with epinephrine across the skin surface.

?A shave removal was then performed with no pain and no bleeding.

?The patient, who felt only a mild tingling during the anesthesia and no discomfort from the biopsy, was quite pleased with this method of anesthesia.

?Thick-skinned areas, like the palms and soles, are not easily anesthetized; the stratum corneum retards the penetration of the drug. Iontophoresis poses some risk for areas of broken skin (ulcerations, erosions, and lacerations) as the lack of stratum corneum causes uneven current flow.

?No distortion of tissues is produced while using iontophoresis, and this provides an advantage over intalesional anesthesia for some skin procedures.

?Bacteria and viruses are not transported by the electrical current, and, since the skin is left intact by the anesthetic procedure, the risk of contamination with iontophoresis is negligible.

?Iontophoresis is effective in delivering lidocaine to the skin without distortion of tissues and without pain.

"Iontophoresis is an excellent method of performing anesthesia for superficial procedures such as shave biopsies and should be used more by dermatologists.

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