Excision of subungual melanoma in situ followed by reconstruction of finger soft-tissue defect using homodigital dorsal adipofascial reverse flap

Subungual melanoma is a rare malignant neoplasm of melanocytes that arises from the nail matrix. In the early phase, it presents as darkened longitudinal band under nail plate (melanonychia), and can be misdiagnosed as benign nail pigmentation disorders such as nail matrix nevi or subungual lentigo. It is usually more advanced than other melanomas at the time of diagnosis and has therefore relatively poor prognosis. Wide excision with phalanx amputation was once considered the first-line therapy, but in recent years there is a trend toward a more conservative approach