Squamous cell carcinoma of the hand masquerading as a cutaneous infection

SUMMARY A 33-year-old male concreter presented with a small abscess on his right index finger following an injury at work. Histological examination of the lesion was consistent with chronic inflammation and Staphylococcus aureus, Streptococcus anginosus and Escherichia coli were isolated on cultures. The lesion was treated as a chronic fungal infection with bacterial superinfection. Seventeen months later, a bone scan showed periarticular involvement, and a diagnostic biopsy identified a well-differentiated squamous cell carcinoma. He underwent amputation of his index and middle fingers. After 4 years of follow up, there has been no evidence of recurrence at the primary site, but he has since developed two further primary squamous cell carcinomas. This case emphasizes the importance of considering malignancy when dealing with chronic infections of the hand.