Onycholemmal Carcinoma: A Rare Nailbed Tumor Managed With a Digit-Sparing Approach

Area of Science:

• Dermatology
• Oncology
• Surgical Pathology

Background:

• Onycholemmal carcinoma is a rare squamous cell carcinoma originating from the nailbed epithelium.
• Limited literature (16 reports) exists, lacking standardized diagnostic and management protocols.
• Current treatment often involves digital amputation, impacting patient function and aesthetics.

Purpose of the Study:

• To present a case of onycholemmal carcinoma.
• To discuss diagnostic challenges associated with this rare malignancy.
• To advocate for conservative, digit-sparing treatment strategies.

Main Methods:

• Case presentation of a patient with onycholemmal carcinoma.
• Review of diagnostic modalities and histopathological findings.
• Discussion of treatment options, emphasizing limb preservation.

Main Results:

• The case highlights difficulties in early and accurate diagnosis.
• Standard treatment involved amputation, but alternative approaches were considered.
• Successful management of similar cases may be achievable with a tailored, conservative strategy.

Conclusions:

• Onycholemmal carcinoma diagnosis can be challenging due to its rarity and non-specific presentation.
• A digit-sparing approach may be feasible and preferable to amputation in select cases.
• Further research and case reporting are needed to establish evidence-based management guidelines.