Mimical reconstruction and aesthetic repair of the nail after resection of subungual melanocytic nevus

BACKGROUND: This study aimed to report the outcomes of mimical reconstruction and aesthetic repair of the nail. METHODS: When the pigmented bands were more than 1/2 the width of the whole nail, mimical reconstruction of the nail was performed, with a lateral toe pulp island flap covering the wound via the subcutaneous channel. If the pigmented bands were 1/4 to 2/5 the width of the entire nail, aesthetic repair of the nail was carried out by split-thickness excision under a microscope. RESULTS: The average age of patients at the time of surgery was 14.5 years. Five patients had lesions on their toes, while three had lesions on their fingers. There were no post-operative complications. All toenails of the five patients who had undergone mimical reconstruction exhibited a well-settled flap. The nails of the three patients who underwent aesthetic repair displayed no nail malnutrition or deformity, and all nails had an aesthetic appearance. CONCLUSIONS: Both mimical reconstruction and aesthetic repair of the nail following resection of subungual melanocytic nevus are reliable and feasible. The “like tissue” repairs of complex nail defects appear to be satisfactory. All patients had excellent aesthetic outcomes. LEVEL OF EVIDENCE: V SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-021-01423-9.