Micrographic surgery for subungual squamous cell carcinoma

Eight patients were treated for subungual squamous cell carcinoma (4 female, 4 male; mean age 61 years). History of disease ranged from 9 months to 14 years (mean 4.7 years). Outpatient surgery under local anaesthetic was performed using Mohs micrographic surgery and formalin-fixed histological specimens. Tumour clearance was achieved after 2-6 procedures (median 3) over a mean period of 6.9 days. In all cases the wounds were allowed to heal by secondary intention and the distal phalanx was preserved. During a mean follow-up period of 3.1 years (range 0.5-6), no recurrence was seen and involved digits remained functional. Mohs micrographic surgery can provide a valuable alternative to amputation for subungual squamous cell carcinoma.