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Presentation, microsurgical therapy, and clinical outcomes in three cases of expanding melanonychia of the nail unit in children

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Details

Original languageEnglish
Pages (from-to)1453-1457
Number of pages5
JournalArchives of Orthopaedic and Trauma Surgery
Volume131
Issue number10
DOIs
Publication statusPublished - Oct 2011
Publication typeA1 Journal article-refereed

Abstract

The management of expanding melanonychia in childhood is controversial. Here, we present three cases and discuss their operating indications and reconstruction. Between January 1, 1995 and December 31, 2007, one boy and two girls, were operated for expanding melanonychia, involving the thumb, index Wnger or the middle Wnger. They were 2, 4, and 7 years at the time of surgery. A complete resection of the nail plate was performed followed by a direct Wnger reconstruction using a free short-pedicle vascularized nail Xap of the toe. Histology showed a junctional nevus in all cases. The follow-ups were after 2, 3, and 5 years and without any complications or recurrence. Regarding reconstruction, the mean Foucher and Leclère score were, respectively, 17 and 16 points. It is concluded that for expanding melanonychia, in case of doubt, an examination of the entire lesion is necessary. Reconstruction of the nail unit after wide excision with nail plate ablation can be performed using microsurgery as discussed below. However, new guidelines on shave biopsy can make this microsurgical procedure obsolete.

Keywords

  • Expanding melanonychia, Foucher score, Microsurgery, Nail-reconstruction, Toenail complex