Clinical Retrospective Study Of Longitudinal Melanonychia

ObjectiveLongitudinal melanonychia(LM)is a common clinical disease with benign and malignant distinctions.Patients who come to the hospital are often worried about malignant transformation.The diagnosis requires pathological examination,which may cause deformation of the nails.The medical records of patients with LM admitted to the Department of Plastic Surgery,the First Affiliated Hospital of Zhengzhou University are summarized.The epidemiological characteristics,clinical manifestations,pathological classification,treatment,prognosis,etc.are combined with relevant domestic and foreign journals and literature reports.A clinical retrospective study was conducted to investigate the clinical manifestations and pathological differences of longitudinal black nails,the effect of surgical methods on postoperative complications and recurrences,providing new ideas for clinical treatment.MethodsThe clinical data of patients with longitudinal black nails admitted to the Department of Plastic Surgery,the First Affiliated Hospital of Zhengzhou University from January 2012 to September 2018,including surgical methods,pathological findings,postoperative complications and follow-up results were retrospectively analyzed.Part of the data was processed using SPSS 19.0 software for retrospective case analysis.Results1.The width of the LM band is different between adults and minors(p<0.05).The width of the adult pigment band is wider than that of the minor.The LM is accompanied by a malnutrition and finger/toe end.Pain and recent changes were more common in adults than in adults(p<0.05).Among the clinical features of benign and malignant longitudinal black nails in adults,lesion width,marginal condition,Hutchinson’s sign,nail dystrophy,pain,recent changes were statistically significant(p<0.05),lesion width was >0.6 cm,and the margin was unclear.Hutchinson sign positive,nail malnutrition,pain,and recent changes are more common in malignant LM.2.There were significant differences in the distribution of longitudinal pathological black between adults and minors,between fingers and toes(p<0.05),and longitudinal black nails were more common among fingers(80%).There was no significant difference in pigmentation between adults and minors(p>0.05).There was a statistically significant difference between beetle-like sputum,sputum,and melanoma(P<0.05).Melanoma is more common in the adult group(60%,100.0%),and the mother-in-law is more common in the minor group(76.19%).3.The difference between the age of the first occurrence of A-black line and the age of diagnosis was statistically significant(P<0.05),and there was a delay in diagnosis.4.The pearson correlation coefficient value of width and disease duration is r=0.275,and its actual significance level is 0.001<0.01.There is a positive correlation between the two.5.Of the 147 patients with benign longitudinal black nails,9(6.12%)had recurrence.Among the relapsed patients,6 were minors,3 were adults;2 were pigmented,1 was freckle-like sputum,and 6 were sputum.Two of the 9 patients with malignant longitudinal black nails relapsed and died 1 year and 3 years after surgery.6.Benign LM in different surgical methods on the postoperative nail shape changes in patients with statistical significance(p <0.05),direct resection of the nail / toenail without deformity,nail longitudinal sputum,nail crack more common,armor After the recurrence of the nails,the nails were narrowed.The width of the lesions in the longitudinal black nails of the direct resection and suture was statistically significant(p<0.05),and the lesion width was(0.1,0.2)cm in patients with lesion width ≤0.1.There were many nail deformities after surgery.Conclusion1.There is a delay in diagnosis of LM;2.The pathological type of LM in minors is mostly a mother-in-law,and melanoma is very rare.Adult LM have lesion width >0.6cm,unclear margin,Hutchinson sign positive,nail malnutrition,pain,and recent changes need to be alert to melanoma;3.The width of LM lesions is positively correlated with the course of the disease.Different surgical methods have an effect on the shape change of the nails after surgery.For patients with LM requiring surgery,early surgery can be considered to reduce the chance of postoperative nail deformity.