Supplies

Lidocaine 2% (Xylocaine)

Triamcinolone acetonide (Kenalog; 40 mg per mL)

21- and 25-gauge needles on 3-mL syringes

Povidone-iodine solution

Gauze

Bandage

Procedure

Clean the area with povidone-iodine solution

Using a 25-gauge needle, inject 1 to 2 mL of lidocaine 2% into the nodule (proximal to and along the sides of the nodule)

Using a 21-gauge needle, inject 2 to 3 mL triamcinolone acetonide (depending on size of nodule) into the nodule perpendicular to the axis of the digit; make injections in a star pattern

If it is difficult to access the nodule, use forceps to bend the needle by 45 degrees (see Figure 2)

Clean the area and apply dressing