TY - JOUR
T1 - Nail Unit Melanoma in Situ Treated with Mohs Micrographic Surgery
AU - Matsumoto, Andrew
AU - Strickland, Nicole
AU - Nijhawan, Rajiv I.
AU - Srivastava, Divya
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - BACKGROUNDMohs micrographic surgery (MMS) is under used in the treatment of nail unit melanoma in situ (MIS), with limited studies in the literature.OBJECTIVEReport clinical outcomes for nail unit MIS using MMS with melanoma antigen recognized by T cells-1 (MART-1) immunostaining.METHODSA retrospective observational study at a single academic institution of patients with a diagnosis of nail unit MIS treated with MMS with MART-1 immunostaining from January 1, 2006, to December 30, 2016. The primary outcome measure was the recurrence rate after MMS.RESULTSFourteen patients were identified. With an average follow-up of 6.0 years (71.6 months; range = 5-139 months), 1 patient developed recurrence 6.6 years after undergoing initial MMS, requiring amputation with no further treatment or recurrence thereafter.CONCLUSIONMohs micrographic surgery for nail unit MIS offers a high cure rate similar to other surgical modalities and can reduce the need for digital amputation. The evolution of the Mohs technique over time, namely, using MART-1 immunostaining, has led to improvement in treatment outcomes. Performing complete nail unit excision with nail plate remaining intact attached to the nail bed may also contribute to improved outcomes. Further refinement in technique and more data are necessary to continue to advance this treatment.
AB - BACKGROUNDMohs micrographic surgery (MMS) is under used in the treatment of nail unit melanoma in situ (MIS), with limited studies in the literature.OBJECTIVEReport clinical outcomes for nail unit MIS using MMS with melanoma antigen recognized by T cells-1 (MART-1) immunostaining.METHODSA retrospective observational study at a single academic institution of patients with a diagnosis of nail unit MIS treated with MMS with MART-1 immunostaining from January 1, 2006, to December 30, 2016. The primary outcome measure was the recurrence rate after MMS.RESULTSFourteen patients were identified. With an average follow-up of 6.0 years (71.6 months; range = 5-139 months), 1 patient developed recurrence 6.6 years after undergoing initial MMS, requiring amputation with no further treatment or recurrence thereafter.CONCLUSIONMohs micrographic surgery for nail unit MIS offers a high cure rate similar to other surgical modalities and can reduce the need for digital amputation. The evolution of the Mohs technique over time, namely, using MART-1 immunostaining, has led to improvement in treatment outcomes. Performing complete nail unit excision with nail plate remaining intact attached to the nail bed may also contribute to improved outcomes. Further refinement in technique and more data are necessary to continue to advance this treatment.
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U2 - 10.1097/DSS.0000000000002682
DO - 10.1097/DSS.0000000000002682
M3 - Article
C2 - 32796325
AN - SCOPUS:85105698083
SN - 1076-0512
VL - 47
SP - 98
EP - 103
JO - Dermatologic Surgery
JF - Dermatologic Surgery
IS - 1
ER -