Subunguales Plattenepithelkarzinom

Abstract

A 63-year-old patient presented with a 12-month history of a subungual tumor on the right middle finger. The patient had had a similar lesion involving his left index finger 5 years ago, which was identified as a subungual squamous cell carcinoma. Ablation of the nail plate, the nailbed and the matrix was performed. Histopathology confirmed another subungual squamous cell carcinoma. The patient received a full thickness skin graft. Subungual squamous cell carcinomas are among the most frequently reported types of subungual malignancies. However, subungual squamous cell carcinomas arising in more than one digit have been reported only rarely. The cause of subungual squamous cell carcinoma has not been clearly identified, they has been associated with radiation, chronic infection, arsenic ingestion, HPV infection and trauma.

Subungual Squamous Cell Carcinoma Associated with Long Standing Onychomycosis: Aggressive Surgical Approach with a Favourable Outcome

“…Multiple finger involvement has also been described [ 5 ]. The incidence is higher in men between the fifth and seventh decades of life [ 1 , 2 , 6 , 7 ]. The rare occurrence and indolent natural history of SSCC, along with the higher prevalence of other benign conditions affecting the ungual apparatus, often mislead the physician with a subsequent delay in the correct diagnosis and therapy, potentially leading to disease progression [ 2 ].…”

“…Late symptoms usually associated with an advanced process, including nodular lesions of the nail, bleeding, ulceration, or a large exophytic mass, are highly suggestive of malignancy [ 5 , 6 ]. In particular, in any rapidly growing ulcerative lesion, a potential malignancy should be considered, especially SSCC [ 7 ]. Also, a lack of response to antifungal or antibacterial therapy is strongly suggestive of malignancy, virtually always requiring a subungual biopsy [ 6 , 7 ].…”

“…In particular, in any rapidly growing ulcerative lesion, a potential malignancy should be considered, especially SSCC [ 7 ]. Also, a lack of response to antifungal or antibacterial therapy is strongly suggestive of malignancy, virtually always requiring a subungual biopsy [ 6 , 7 ].…”