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 (Fig 1).
Benign dermal nevus.
Lesions of this type can easily be removed for cosmetic reasons by means of shave technique. The nose, however, can be a painful area to anesthetize with injection of local anesthetics; younger patients often cannot or will not tolerate needle sticks into their face. Several methods to reduce the pain of anesthesia have been used in the past. Iontophoresis with lidocaine and epinephrine has been reported in the medical literature as an efficient and painless
Maloney JM. Local Anesthesia Obtained via Iontophoresis as an Aid to Shave Biopsy. Arch Dermatol. 1992;128(3):331-332. doi:10.1001/archderm.1992.01680130045004