Thoughts on surgical excision of onychopapilloma.

Although onychopapilloma (OP) is a benign tumor of the nail bed and distal matrix, there is nevertheless a demand for treatment in some patients. Classical longitudinal excision (CLEx) with avulsion of the nail plate was the most suitable surgical procedure. However, there may be better ways to produce a pleasing esthetic effect. The aim of this study was to modify CLEx to render it more effective, reduce the rate of recurrence, and achieve better esthetic results. We identified 23 patients with OP in varying clinical manifestations that were treated with CLEx and modified CLEx with or without avulsion of the nail plate. With the procedure of modified CLEx without avulsion of the nail plate, there was no bleeding as a side effect and recovery was faster. The appearance of the nail was nearly unchanged and no patient complained about the cosmetic results. We modified CLEx to treat OP to improve the esthetic effect while maintaining surgical effectiveness.