A shave biopsy is done on this forearm skin lesion to determine if it a skin cancer. It will require further treatment if it is a skin cancer and there is remaining cancer present at the margins of the biopsy sample. It may be a benign seborrheic keratosis. It could also be either a basal cell carcinoma or a squamous cell carcinoma.
The skin is anesthetized with lidocaine with epinephrine and a just about 10% volume sodium bicarbonate. The sodium bicarbonate buffers the lidocaine to reduce the sting felt by the patient.
I don’t think Irl was joking when he said that he felt the procedure.
On occasion, we will rarely have a patient who does not get full anesthesia with our usual anesthetic injection. I felt really badly that Irl felt anything. It was probably still much less painful thatn it would have been without anesthesia. You can see from many of our other videos that the patient usually has no painful reaction after being anesthetized.
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