RESUMO
INTRODUCTION: Longitudinal melanonychia is a diagnostic and treatment problem for the surgeon. Fear of melanoma most frequently leads to total excision of nail bed, matrix and plate. METHOD: Twenty two patients, aged from 7 to 77, were operated on from 89 to 98 in our department, using different techniques (total matrix biopsy, total excision of melanonichia with direct suture, Schernberg flap). RESULTS: Thumb and index are predominant locations (11 out of 16). No malignant lesions were found histologically. Aesthetic sequellae were frequent and directly linked to the width and location of the melanonychia. Limited matrix biopsy produce the best aesthetic result. DISCUSSION: Malignant lesions are rare and our series is short. Therefore an additional multicentric study is required. Our choice is to make a limited matrix biopsy in the first place with a minimal aesthetic prejudice. Histology determines the treatment choice: excision or follow up.
