Mimical Reconstruction and Aesthetic Repair of the Nail After Resection of Subungual Melanocytic Nevus

Abstract

Background: Previous studies have shown about 25% - 33% of cutaneous melanomas result from melanocytic nevi. Currently, there are no consensus on treatment of the subungual melanocytic nevi with the pigmented band width > 3mm. However, some options change post-operative nail appearance and cannot obtain a well aesthetic outcome. The purpose of this study is to report the outcomes of mimical reconstruction and aesthetic repair of the nail.Methods: When the width of the pigmented bands was more than 1/2 of the whole nail width, the mimical reconstruction of the nail, the lateral toe pulp island flap covered the wound via the subcutaneous channel, was performed. If the width of the pigmented bands ranged from 1/4 to 2/5 of the entire nail, the aesthetic repair of the nail, the split-thickness excision under microscope, would be carried out.Results: The average age at the time of surgery was 14.5 years. The lesions were located at the toes in 5 patients and fingers in 3 patients. No complications occurred postoperatively. In 5 patients with the mimical reconstruction of the nail, all of toenail showed well-settled flap. In three patients with the aesthetic repair of the nail, there was no nail malnutrition or deformity, and all nails have an aesthetic appearance.Conclusions: Mimical reconstruction and aesthetic repair of the nail following resection of subungual melanocytic nevus is a reliable and feasible. It seems to be satisfactory that “like tissue” repairs the complex nail defects. All patients obtain an excellent aesthetic outcome.