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Subungual squamous cell carcinoma masquerading as a melanotic macule
1National Skin Centre, 1 Mandalay Road, Singapore 308205. hazeloon@nsc.gov.sg
Singapore Medical Journal
|March 26, 2008
Summary
Subungual squamous cell carcinoma, a rare cancer, often presents as subtle nail changes, delaying diagnosis. Early nail biopsy and prompt treatment are crucial for preserving joint function.
Area of Science:
- Oncology
- Dermatology
- Nail Diseases
Background:
- Subungual squamous cell carcinoma (SCC) is an uncommon malignancy.
- It frequently mimics benign nail conditions, leading to diagnostic delays.
Observation:
- A 43-year-old man presented with a three-year history of a slow-growing melanotic macule on his fingernail.
- Punch biopsy confirmed well-differentiated squamous cell carcinoma.
Findings:
- Histological analysis revealed well-differentiated squamous cell carcinoma.
- Surgical management involved wide local excision and full-thickness skin grafting.
Implications:
- A high index of clinical suspicion is necessary for early diagnosis of subungual SCC.
- Prompt nail biopsy and timely tumor excision can prevent joint damage and preserve function.
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