Clinical Image
Subungal Squamous Cell Carcinoma - A Missed Diagnosis
Nauman Saeed2, Baljinder Singh Dhinsa1*, Dilip Pillai1, Anant Narayam Mahapatra2
1Consultant Orthopaedic Surgeon, William Harvey Hospital, Kennington Road, Wilesborough, United Kingdom
2Our Lady of Lourdes Hospital, Drogheda, Ireland
*Corresponding author: Baljinder Singh Dhinsa. Consultant Orthopaedic Surgeon, William Harvey Hospital, Kennington Road, Willesborough, United Kingdom
Published: 10 Nov, 2017
Cite this article as: Saeed N, Dhinsa BS, Pillai D,
Mahapatra AN. Subungal Squamous
Cell Carcinoma - A Missed Diagnosis.
Clin Oncol. 2017; 2: 1365.
Clinical Image
Subungal squamous cell carcinoma is a rare entity. These tumours may present with nail plate discolouration or deformity, paronychia, ulceration and pain, usually affecting a single digit. Common mistaken diagnosis’ are paronychial infection, pyogenic granuloma, subungal haematoma, onychomycosis and chronic osteomyelitis. Whilst it is a slow growing low-grade malignancy, delay in management may lead to osseous involvement and metastasis. Suspicion should be raised by nail deformity or paronychial infections that do not improve with treatment, as well as bleeding and ulceration. It is most commonly seen in males after the 5th decade of life. Diagnosis is achieved with biopsy for histology analysis. Surgical management options include excision (marginal or wide excision) and distal phalanx amputation, whilst radiotherapy has been reported as demonstrating low recurrence rates if used as primary treatment.
Figure
Figure