Periungual basal cell carcinoma

Abstract

Periungual basal cell carcinoma is rare and needs to be differentiated from other common diseases that affect this region. Several factors are associated with the development of this tumor, and sun damage seems to play an important role in its pathogenesis. Dermoscopy of clinically indolent lesions on the nail unit can shorten the diagnostic process and avoid destructive treatment and functional damage.

Subungual Basal Cell Carcinoma: A Rare Nail Tumor with a Challenging Diagnosis

“…Risk factors include exposure to radiation and chemical therapies, burns, viruses, chronic trauma, azo dyes and arsenic-containing compounds [1, 2]. Arsenic exposure was reported by our patient.…”

“…The clinical presentation in the periungual and subungual regions is usually variable and may be misidentified with chronic paronychia, pyogenic granuloma, squamous cell carcinoma, amelanotic melanoma, trauma, dermatophyte and bacterial infections, and eczema [4, 5]. Dermatoscopy contributes to the diagnosis and evidence of alterations such as arboriform telangiectasia, seen in periungual BCC, and the destruction of the nail matrix, frequently found in nail tumors [2]. The average age of patients with BCC is 65 years, and the male-to-female ratio is 1.8: 1 [1].…”

“…Treatment includes the use of topical imiquimod, radiation therapy, topical 5-fluorouracil, intralesional interferon, electrodesiccation and curettage, cryosurgery, laser, standard excision and Mohs micrographic surgery; the last 2 of these techniques are the most widely used and are associated with a reduced probability of relapse [1, 2, 5]. When long-term topical treatments of nail lesions fail to demonstrate improvement, anatomopathology should be used to investigate for the presence of tumoral lesions.…”

“…Basal cell carcinoma (BCC) is the most common type of skin cancer [1, 2]. Nail involvement of this tumor is rare, and the pathogenesis is not entirely clear.…”

“Basal cell carcinoma of the hand: A systematic review and meta-analysis of incidence of recurrence”

“…The following reasons prompted the exclusion of 59 articles: improper methods (systematic review, review article, and letter to editor), n = 12, no outcome of interest ( n = 19), the full text could not be located ( n = 14), the specific location of BCC was not stated ( n = 12), included non-hand BCC patients ( n = 2). Thirty-five studies were case reports, 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 2 studies were case series, 53 , 54 1 study was a prospective cohort analysis, 55 and the remaining studies were retrospective cohort studies. Two studies were published in Australia, 27 , 40 6 studies were published in Asia, 22 , 23 , 27 , 32 , 47 , 49 17 studies were published in Europe, 8 , 19 , 25 , 34 , 35 , 38 .…”