Subungual squamous cell carcinoma

Digital squamous cell carcinoma and association with diverse high-risk human papillomavirus types

“…Incidence of bony invasion from nail bed SCC has been reported to be as high as 55% to 60%. 4,26,27 Amputation is the treatment of choice for bony invasion, and we are unaware of any reported cases of recurrence after amputation. For SCCs involving only soft tissue, Mohs micrographic surgery offers the highest cure rates.…”

Primary Malignant Tumors of the Nail Unit

“…Histologic confirmation of such changes has documented true invasion in only 6 of 10 cases studied. 28 Conversely, in one study of 8 patients with "negative" preoperative radiology studies, 2 of 8 showed involvement of periosteum from the terminal phalanx on formalin-fixed Mohs sections. 26 Clearly, preoperative radiographic staging is imperfect and needs to be interpreted on a case-to-case basis.…”

“…In many cases, the diagnosis is missed because it was not considered in the differential diagnosis. 28 The presenting symptoms may mimic inflammatory diseases, benign tumors, or infections (Table 1). With all the diagnoses in Table 1, but particularly with verrucous lesions, the practitioner needs to maintain a high degree of suspicion and a low threshold for biopsy of ambiguous diseases of the nail unit.…”

“…Amputation of the distal phalanx is often not adequate and should be considered only if there are no radiologic changes." 28 Concurrently, practitioners were experimenting with topical 5-fluorouracil, curettage and electrodessication, and radiation, all of which were less curative than amputative surgery, including a 75% recurrence rate with electrosurgery. Radiation therapy has also been associated with bone necrosis.…”

Subungual Squamous Cell Carcinoma Masquerading as an Onychomycosis

“…Sentinel lymph node biopsy is generally not considered part of the surgical algorithm for management because axillary lymph node involvement and distant metastasis are uncommon [4]. However, distant metastasis is rare and fatal [12,13]. For this reason, a long term 3-10 years follow-up is recommended due to indolent course.…”