Mohs Micrographic Surgery of the Nail Unit and Squamous Cell Carcinoma

Abstract

The nail unit can be a challenging anatomic location for surgical removal of neoplasms. Although uncommon, malignancies do affect this specialized epithelial structure. In particular, Bowen's disease and more invasive squamous cell carcinoma (SCC) are the most common neoplasms to affect the nail unit and surrounding structures. Other neoplasms such as basal cell carcinoma and malignant melanoma can also affect the nail unit, but less frequently, and will not be discussed in the scope of this review. Mohs micrographic surgery continues to be the treatment of choice because of the procedure's tissue-sparing qualities. A clear understanding of the anatomy and the histology of the nail unit, a review of the technique of Mohs surgery of the nail anatomy, as well as a review of the literature are presented.

Cutaneous squamous carcinoma in situ (Bowen's disease): Treatment with Mohs micrographic surgery

“…These studies mainly focus on the use of MMS in specific locations, such as the penis and nail unit. 22,23 We recently reported the outcome of MMS in a series of patients with periocular BD, showing a recurrence rate of 5% and 12% for primary and recurrent lesions, respectively, over more than 5-years of follow-up. 24 These patients are included in this larger series.…”

Cauterization of the germinal nail matrix using phenol applications of differing durations: A histologic study

“…Along the basal cell layer, the end product is the hard keratin nail plate or onychocytes. 56 These results can help the clinician maximize the benefits and limit the detrimental effects of phenol matricectomy in the dermatologic patient.…”

Bowen’s disease of the nail apparatus: a series of 8 patients and a literature review

“…Treatment of BD of the nail apparatus by Mohs surgery provides high remission rates [17][18][19]. Defect in size and shape defines the type of closure.…”