Depending on what the doctor is looking for or “ruling out” by taking the biopsy, this can be done one of two ways. Most commonly, the nail is trimmed and any broken or crumbly nail is also scraped gently away and placed in the specimen bag. In instances where there is a dark brown spot or change in appearance that is not at the end of the nail, this may be done by numbing the toe and taking a small circle of the nail out with a punch biopsy.