A Call for Evidence-Based Conservative Management of Nail Unit Malignancies

Stiff, Katherine M; Jellinek, Nathaniel J.; Knackstedt, Thomas

doi:10.1097/prs.0000000000008968

Cited by 5 publications

(2 citation statements)

References 89 publications

(156 reference statements)

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“…The references of relevant reviews [7,[35][36][37] were searched for further references to relevant studies.…”

Section: Information Sources and Search Strategymentioning

confidence: 99%

Surgical excision methods for skin cancer involving the nail unit: A systematic review

Hardie,

Wade,

Wormald

et al. 2023

Cochrane Evidence Synthesis and Methods

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IntroductionSkin cancer affecting the nail unit is rare but is associated with morbidity, and melanoma has a high mortality rate. The principal treatment is surgical excision and methods can be classified into digit‐sparing surgery or amputation. Digit‐sparing surgery (wide excision or Mohs surgery) may be safe and effective for malignancies involving the nail unit in comparison to amputation if there is not bony invasion. The objective was to assess the efficacy and safety of different methods of surgical excision for skin cancer involving the nail unit.MethodsProspective comparative studies (randomized controlled studies, non‐randomized controlled studies and prospective observational studies) of surgical excision for skin cancer of the nail unit in all participants were eligible for inclusion. We searched electronic databases, trials registers and conference abstracts. We checked the reference lists of included studies and related systematic reviews for further references to relevant studies, and we contacted experts to enquire if they were aware of any additional relevant trials. We used standard methodological procedures expected by Cochrane. The primary outcomes were overall survival, disease free survival and adverse events/outcomes at 30 days. The secondary outcomes were quality of life outcomes. We planned to use GRADE to assess the quality of the evidence for each outcome.ResultsWe did not identify any studies that met the inclusion criteria for this review. We have been unable to assess our outcomes of overall survival, disease free survival, adverse events/effects and quality of life.ConclusionsAs we have not identified any studies for inclusion, we are unable to assess the efficacy and safety of different methods of surgical excision for skin cancer involving the nail unit. We suggest that comprehensive cancer registry analysis is required in this field to obtain meaningful data.

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“…The references of relevant reviews [7,[35][36][37] were searched for further references to relevant studies.…”

Section: Information Sources and Search Strategymentioning

confidence: 99%

Surgical excision methods for skin cancer involving the nail unit: A systematic review

Hardie,

Wade,

Wormald

et al. 2023

Cochrane Evidence Synthesis and Methods

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“…It is now widely admitted that the treatment of malignant subungual tumour (MSUT), such as in-situ and minimally invasive subungual melanoma (SUM) and subungual squamous cell carcinoma (SUSCC) without bone invasion, relies on functional surgery, meaning a wide local excision (WLE) of the nail unit down to the bone with safe margins. [1][2][3][4][5][6] After WLE, diverse reconstruction methods have been reported previously, including secondary intention healing (SIH), full-thickness skin grafting (FSG), composite nail unit grafting, local or free flap, artificial dermis grafting and many combined approaches. 4,[7][8][9][10][11][12] Among them, the SIH and the FSG are the most used.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of different reconstruction methods after wide local excision of the nail unit: A retrospective study

Li,

Jiang,

Huang

et al. 2023

Acad Dermatol Venereol

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BackgroundWide local excision (WLE) of the nail unit is widely used in treating in‐situ and minimally invasive malignant subungual tumours. After WLE, diverse reconstruction methods have been reported. However, the best repair method has yet to be determined.ObjectiveTo compare the repair effects and postoperative morbidity of secondary intention healing (SIH), artificial dermis grafting combined with secondary intention healing (ADGSIH), and full‐thickness skin grafting (FSG) after WLE of the nail unit.MethodsWe retrospectively reviewed 21 patients who underwent WLE of the nail unit. The re‐epithelializing time, functional and cosmetic outcomes, postoperative complications, and patients’ satisfaction were assessed from the follow‐up records.ResultsThe FSG group showed more rapid healing and better functional and cosmetic outcomes than the SIH and ADGSIH groups. The ADGSIH and FSG groups showed significant pain relief compared to the SIH group. No serious early and late postoperative complications were reported. The median follow‐up period was 26 months, and no recurrence was observed. All patients were satisfied with the treatment.ConclusionsFSG after the WLE of the nail unit is a therapeutic option with convenient application, significant pain relief, rapid recovery, and satisfying functional and cosmetic outcomes.

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Low local recurrence rates after Mohs micrographic surgery for cutaneous squamous cell carcinoma of the nail unit

Veerabagu,

Zhang,

Krausz

et al. 2024

Journal of the American Academy of Dermatology

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A Call for Evidence-Based Conservative Management of Nail Unit Malignancies

Cited by 5 publications

References 89 publications

Surgical excision methods for skin cancer involving the nail unit: A systematic review

Surgical excision methods for skin cancer involving the nail unit: A systematic review

Comparative efficacy of different reconstruction methods after wide local excision of the nail unit: A retrospective study

Low local recurrence rates after Mohs micrographic surgery for cutaneous squamous cell carcinoma of the nail unit

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