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Background. The inherited accessory nail of the fifth toe is a common condition in the Chinese population.

Objective. The objective was to demonstrate three lesions in two cases of inherited accessory nail of the fifth toe successfully treated with surgical matricectomy.

Methods. Under local anesthesia and use of tourniquet, the proximal nail fold was incised and the matrix of the accessory nail was exposed and then excised by scalpel surgery. The skin defect left after removal of the lesion was repaired with a rotation flap.

Results. Histopathologic examination of the surgical specimens revealed that the matrices of the accessory nails were completely extirpated. No recurrence was found 2 years after operation.

Conclusion. The inherited accessory nail of the fifth toe was cured by surgical matricectomy.