[Surgical interventions on the nail: indications and contraindications].

Nail surgery might be performed for diagnostic and therapeutic reasons. A diagnostic biopsy is indicated for unclear disturbances of nail formation, atypical inflammations, suspicious pigmentations and neoplasias of the nail organ. The following alterations have to be absolutely treated by surgery: solitary pigmented streaks, tumors, ingrowing nails (stage III), panaritium and traumatic injuries of the nail organ. Relative surgical indications are onychogryposis, nail mycoses, discolorations due to chromogenic bacteria and subungual warts, as well as large subungual haematomas, longitudinal split nails and recalcitrant chronic paronychias. However, there are some contraindications for surgical intervention especially for simple avulsions of the nail plate. With malformed nails due to matrix diseases, large scars of the nail bed or ingrowing nails, an extraction of the nail plate does not have any healing effect. Instead repeated nail extractions may cause thickening and overcurvature of the nail.