[Malignant nail tumors].

Area of Science:

• Dermatology
• Oncology
• Pathology

Context:

• The distal phalanx harbors diverse tissues, leading to a variety of malignant tumors around the nail apparatus.
• Nail malignancies present unique diagnostic challenges due to their varied presentations.

Purpose:

• To review the spectrum of malignant tumors affecting the nail apparatus.
• To highlight the clinical features, diagnostic considerations, and treatment modalities for common nail malignancies.

Summary:

• Bowen disease, a common nail malignancy, presents as a verrucous plaque and can progress to invasive squamous cell carcinoma.
• Ungual melanoma, the second most frequent nail malignancy, can be pigmented (matrix origin) or amelanotic (nail bed origin) and may be misdiagnosed.
• Treatment for subungual melanomas ranges from nail apparatus extirpation to distal amputation for advanced cases.

Impact:

• Emphasizes the need for high clinical suspicion for isolated or single-digit proliferations unresponsive to conservative treatment.
• Underscores the importance of accurate diagnosis for effective management of nail apparatus malignancies.