Secondary Intention Healing After Functional Surgery for in Situ or Minimally Invasive Nail Melanoma

Jo, Gwanghyun; Hur, Keunyoung; Cho, Soo Ick; Mun, Je‐Ho

doi:10.2340/00015555-3541

Cited by 12 publications

(16 citation statements)

References 14 publications

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“…Defects following excision can be reconstructed by secondary intention healing, skin grafts, cross-finger flaps, or thin flaps. 77,84,[86][87][88] Mohs surgery is an alternative technique for the management of NM with a recurrence rate of 0-14%. [89][90][91] However, this technique is challenging because of the difficulty in identifying pathologic melanocytes at the lesion's margins.…”

Section: Managementmentioning

confidence: 99%

“…NMIS treatment requires wide excision, including the nail plate, nail bed, and matrix 14,16,82 . Complete removal of the nail apparatus with a 5 mm tumor‐free margin from the nail unit or Hutchinson's sign is satisfactory 77,83,84 . As the distance between the matrix and the underlying bone is narrow (<2 mm), 85 we recommend total nail apparatus excision including the periosteum during FS 84 .…”

Section: Managementmentioning

confidence: 99%

“…In this procedure, sufficient knowledge of nail anatomy is needed to ensure appropriate incision in the proximal nail fold and conservation of the extensor hallucis tendon. Defects following excision can be reconstructed by secondary intention healing, skin grafts, cross‐finger flaps, or thin flaps 77,84,86–88 …”

Section: Managementmentioning

confidence: 99%

“…14,16,82 Complete removal of the nail apparatus with a 5 mm tumor-free margin from the nail unit or Hutchinson's sign is satisfactory. 77,83,84 As the distance between the matrix and the underlying bone is narrow (<2 mm), 85 we recommend total nail apparatus excision including the periosteum during FS. 84 In this procedure, sufficient knowledge of nail anatomy is needed to ensure appropriate incision in the proximal nail fold and conservation of the extensor hallucis tendon.…”

Section: Managementmentioning

confidence: 99%

“…77,83,84 As the distance between the matrix and the underlying bone is narrow (<2 mm), 85 we recommend total nail apparatus excision including the periosteum during FS. 84 In this procedure, sufficient knowledge of nail anatomy is needed to ensure appropriate incision in the proximal nail fold and conservation of the extensor hallucis tendon. Defects following excision can be reconstructed by secondary intention healing, skin grafts, cross-finger flaps, or thin flaps.…”

Section: Managementmentioning

confidence: 99%

See 4 more Smart Citations

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

Darmawan

Ohn

Mun

et al. 2022

Acad Dermatol Venereol

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Nail melanoma (NM) is an important differential diagnosis in patients with longitudinal melanonychia. However, diagnosis is often challenging as it is difficult to differentiate from other pigmented nail disorders. The main challenge for diagnosis is obtaining adequate nail matrix biopsy specimens for histopathological assessment. Furthermore, the histopathological changes in the early stages of NM are subtle and contribute to a delay in diagnosis and care. Therefore, the integration of clinical and histopathological analyses is essential. Clinical and dermoscopic features, such as a broadened width of asymmetric bands in an irregular pattern, with multicolour pigmentation, periungual pigmentation, and continuous growth, are features that support the diagnosis of NM. The essential histological features that must be assessed are cellular morphology, architectural features, melanocyte density, and inflammatory changes. The reported mutations in NMs were BRAF (0–43%), NRAS (0–31%), KIT (0–50%), NF1 (0–50%), and GNAQ (0–25%). Surgery is the primary treatment for NM. The recommended treatment for in situ or minimally invasive NM is functional surgery, but cases with suspected bone invasion should be treated with amputation. Targeted therapy and immunotherapy are indicated for advanced stages of NM. This review summarizes the updated guidelines for the diagnosis and treatment of NM.

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Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

See 3 more Smart Citations

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

Darmawan

Ohn

Mun

et al. 2022

Acad Dermatol Venereol

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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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Diagnosis and treatment of subungual melanoma

Oh¹,

Kim²

2023

Arch Hand Microsurg

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Nail melanoma (NM) must be suspected in the initial workup of patients with pigmented nails. However, the differential diagnosis of NM from other nail disorders that involve nail pigmentation is challenging. Dermoscopic, clinical, and histopathological features are integrated for a definite diagnosis. The primary treatment of NM is surgery. Depending on the depth of invasion, amputation or functional surgery can be chosen. This article reviews the clinical, dermoscopic, and histopathological features of NM, as well as its diagnosis and treatment.

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Secondary Intention Healing After Functional Surgery for in Situ or Minimally Invasive Nail Melanoma

Cited by 12 publications

References 14 publications

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics

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

Diagnosis and treatment of subungual melanoma

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