Modified shave surgery combined with nail window technique for the treatment of longitudinal melanonychia: Evaluation of the method on a series of 67 cases

Abstract

Background: Nail matrix histopathologic examination is still the criterion standard to diagnose longitudinal melanonychia (LM).

Objective: To introduce modified shave surgery combined with the nail window technique for managing LM and evaluate the postoperative outcome of the procedure.

Methods: We retrospectively reviewed the medical records of 67 patients with LM who underwent shave surgery combined with the longitudinal-strip nail window technique at our institution from March 2015 to June 2018.

Results: Pathologic diagnosis was accessible in all cases, and 60 cases were assessable for the postoperative outcomes. A total of 45 cases (75.0%) had no postoperative nail dystrophy, and recurrence of nail pigmentation was found in only 8 cases (13.3%).

Limitations: This was a retrospective study.

Conclusion: Modified shave surgery combined with the nail window technique is the preferable management for LM cases, with limited postoperative nail dystrophy and recurrence of pigmentation.

Keywords: longitudinal melanonychia; nail dermoscopy; nail melanoma; nail surgery; nail window technique; onychoscopy; shave surgery; tangential excision; treatment.