Shave biopsy are arguably the single most valuable diagnostic option to dermatologist. It provides a quick, cost effective and efficient means of diagnosing skin lesions for treatment purposes. Patients are typically anesthetized with lidocaine/epinephrine before biopsy. Needle phobia and the burning sensation experienced with lidocaine/epinephrine makes biopsies very uncomfortable for many patients. This leads to the question, does the painful, anxiety inducing shot offset the pain of the superficial shave biopsy?
For this study we will be using the visual pain scale to measure total amount of pain experienced after tangential skin biopsy with lidocaine/epinephrine versus tangential skin biopsy with topically applied ice cubes. Two lesions of comparable dermatomes will be selected on each patient. The control will be the standard of care anesthetic (1% lidocaine w/epinephrine 1:100,000) and the intervention will be ice cubes without lidocaine/epinephrine. We will be holding the plastic wrapped ice on the skin for approximately 30s before the tangential biopsy. The patient will be asked to complete anxiety assessment (prior to the procedure) and pain assessment (after the biopsy) in response to lidocaine/epi and ice. Assessments will be completed for each arm (control and intervention arm).