Subungual squamous cell carcinoma

Abstract

Although subungual squamous cell carcinoma is rare, it is the most common primary malignant neoplasms in this location. The higher incidence occurs in the fingernails, but involvement of the toenails is also possible. Subungual squamous cell carcinoma often looks like other more common benign lesions, such as fungal infection, onychomycosis, or viral wart. These factors, together with a general lack of awareness of this disease among physicians, often result in delayed diagnosis. Therefore, it is underdiagnosed, with few reports in the literature. The authors present a case of a man with a diagnosis of subungual squamous cell carcinoma in the hallux, without bone involvement, which was submitted to the appropriate surgical treatment.

Violaceous lunula with pigmented longitudinal ridge

“…SCC is the most common primary malignant neoplasm of the subungual region, mostly found in middle-aged Caucasian men. 1 Its presence for 20 years without growth, extension, or malignant spread makes this less likely; however, one should always perform biopsy if suspicious. Histology reveals keratin pearls and nests of pleomorphic epithelial cells with abundant cytoplasm extending from the dermis to the epidermis.…”

Subungual arteriovenous hemangioma mimicking subungual malignant tumor

“…SCC of the subungual region, which can also present as a verrucous or granular nodule with destruction of the nail, is the most common malignancy in this area. 5 Therefore, physicians should keep in mind the possibility of AVH when encountering such a case, although biopsy is necessary to reach a definite diagnosis.…”