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Delayed Reconstruction for the Non-Amputative Treatment of Subungual Melanoma

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Author(s)
Byung Ho Oh, Hong Sun Jang, Jungsoo Lee, Min Ju Choi, Kyoung Ae Nam, Kee Yang Chung
Keimyung Author(s)
Oh, Byung Ho
Department
Dept. of Dermatology (피부과학)
Journal Title
Annals of Dermatology
Issued Date
2015
Volume
27
Issue
4
Keyword
AmputationSkin graftNon-amputative wide excisionSecondary intention healingSubungual melanoma
Abstract
Background: In cases of early stage subungual melanoma
(SUM), conservative treatment with non-amputative wide
excision of the nail unit and subsequent skin graft is preferred
over amputation to preserve the involved digit. Objective:
We report a series of patients with SUM treated with conservative
surgery and suggest an effective supplementary
treatment process. Methods: We retrospectively reviewed
10 patients (2 males, 8 females) who were diagnosed with in
situ or minimally invasive SUM on the first biopsy and underwent
non-amputative wide excision of the nail unit. All patients
underwent secondary intention healing during the histopathological
re-evaluation of the entire excised lesion, and
additional treatment was administered according to the final
report. Results: In two of 10 patients, amputation was performed
because of the detection of deep invasion (Breslow
thickness: 4.0, 2.3 mm) from the final pathologic results,
which differed from the initial biopsy. In six patients who received
delayed skin graft, the mean total time required for
complete healing after secondary intention healing and the
skin graft was 66.83±15.09 days. As a result of this delayed
skin graft, the final scarring was similar to the original shape
of the nail unit, scored between 5 and 10 on a visual analogue
scale. Most patients were satisfied with this conservative surgery
except one patient, who had volar portion involvement
and received an interpolated flap instead of a skin graft.
Conclusion: Our treatment process can reduce the risk of incomplete
resection and improve cosmetic outcomes in patients
with SUM.
Keimyung Author(s)(Kor)
오병호
Publisher
School of Medicine
Citation
Byung Ho Oh, Hong Sun Jang, Jungsoo Lee, Min Ju Choi, Kyoung Ae Nam, Kee Yang Chung. (2015). Delayed Reconstruction for the Non-Amputative Treatment of Subungual Melanoma. Annals of Dermatology, 27(4), 417–422. doi: 10.5021/ad.2015.27.4.417
Type
Article
ISSN
1013-9087
DOI
10.5021/ad.2015.27.4.417
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32933
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Dermatology (피부과학)
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