Melanoma management requires consideration of both oncologic and reconstructive principles to optimize both the likelihood of cure and quality of life. The plastic surgeon is encountering melanoma management that requires not only oncologic but also reconstructive surgery while considering both esthetic and functional results. Management of acrolentiginous melanoma typically involves the partial amputation of the thumb or the toe, with removal of the distal phalanx and the adjacent interphalangeal joint. The simple partial amputation of the second phalanx, preserving the pulp and the interphalangeal function (joints and tendinous insertions), and a made-to-measure ungual transfer provide excellent functional and esthetic results while maintaining similar oncologic outcomes. This report attempts to clarify the management of melanoma of the thumb.