Squamous Cell Carcinoma of the Nail Unit: Review of the Literature

Dijksterhuis, Anita; Friedeman, Emmi; Heijden, Brigitte van der

doi:10.1016/j.jhsa.2018.01.010

Cited by 23 publications

(68 citation statements)

References 61 publications

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“…Infiltration into the onychodermis depth of invasion and association with HPV infection are related to a bad prognosis. Bony invasion is observed in approximately 20% of invasive sSCC cases [2, 3]. Because of the rarity of this nail unit tumor, there are not enough published data regarding the treatment for this subtype of squamous cell carcinoma at the subungual location.…”

Section: Discussionmentioning

confidence: 99%

“…The first approach to a suspicious case is to perform an appropriate nail biopsy. If an invasive sSCC is histologically confirmed, it is necessary to perform a radiograph or computed tomography to evaluate bone involvement, a feature that, in some cases, could be difficult to interpret [2, 6] This is the reason why the suggested best imaging study to demonstrate bone infiltration is a magnetic resonance. However, in some instances, the distinction between bone marrow edema and tumor infiltration could be difficult.…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, the distinction between tumor infiltration and other causes of bone marrow edema in the underlying bone is difficult to assess. The treatment of choice in case of bone invasion is amputation of the involved digit [2].…”

Section: Introductionmentioning

confidence: 99%

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Subungual Invasive Squamous Cell Carcinoma with Doubtful Underlying Bone Invasion: A Treatment Proposal

Domínguez‐Cherit

2020

Skin Appendage Disord

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Introduction: Subungual squamous cell carcinoma (sSCC) is the most frequent malignant tumor of the nail unit. When suspecting sSCC, accurate diagnosis is supported by nail biopsy. Depth of invasion and histopathologic signs of human papillomavirus (HPV) infection are related to an unfavorable prognosis. In this case, it is necessary to rule out bone invasion by radiography or MRI, and in case of doubt, amputation is indicated. Case Presentation: We present 2 cases of sSCC with a confirmatory biopsy of sSCC with HPV and invasion; in both cases, MRI was difficult to distinguish between bone invasion and bone marrow inflammation. Before amputating the distal phalanx, we decided to perform a bone biopsy during the excisional surgery. Neither case required amputation. Conclusion: We propose that when an invasive sSCC is present and an MRI is doubtful of bone invasion, before amputating, a bone biopsy should be performed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Subungual Invasive Squamous Cell Carcinoma with Doubtful Underlying Bone Invasion: A Treatment Proposal

Domínguez‐Cherit

2020

Skin Appendage Disord

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“…Squamous cell carcinoma of the nail unit (SCCNU) is the most common tumor of the nail unit and the hand while remaining a rare neoplastic condition overall. 1 The incidence of SCCNU has been approximated at 14 cases per 50 000 (0.028%) dermatology consultations 2 and two cases from 11 400 tumors seen in 1 clinic cohort. 3 Due to under-recognition and misdiagnosis as verruca or onychomycosis, there is often a delay in securing a diagnosis of SCCNU, and the prevalence is likely underestimated.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple digit (also known as synchronous or polydactylous) SCCNU is rare, reported in only 3.9% of cases, and presents additional challenges as it has significant diagnostic and prognostic differences from single-digit (monodactylous) SCCNU. 1 This case report and systematic literature review purports to characterize the rare entity of polydactylous SCCNU by collating all known reported cases in the literature to date. The similarities and differences between monodactylous and polydactylous SCCNU are presented, specifically in relation to clinical presentation, digit distribution, and associated risk factors with the aims of improving physician awareness and improving diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

Polydactylous Squamous Cell Carcinoma of the Nail Unit: A Structured Review of the Literature

Jedlowski

Segal

2020

J Cutan Med Surg

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Squamous cell carcinoma of the nail unit (SCCNU) is a rare neoplastic condition that involves multiple digits (polydactylous SCCNU) in only 3.9% of cases. Here, we report a case of polydactylous SCCNU and perform a comprehensive review of MEDLINE and Embase to collate 44 cases of polydactylous SCCNU reported to date. Polydactylous patients were younger on average (48 to 61-63 years) and had a longer diagnostic delay (44 vs 35.1 months) compared with reported monodactylous cases. Human papillomavirus (HPV) positivity was observed in 49% of cases, and the most common serotypes noted were 16 (25.8%), 73 (16.1%), 58 (9.7%), 18 (6.5%), and 33 (6.5%). Twenty percent of the cases were in immunosuppressed individuals who had a statistically significant lower age at diagnosis (39.33 years vs 51.12 years; P = .01) and diagnostic delay (2.50 months vs 132.46 months, P = .04). Patients with HPV positivity had a lower age at diagnosis (43.74 years vs 53.29 years, P = .04). Environmental exposures noted to be associated with polydactylous disease included X-rays, paint/solvents, soluble oils, and stagnant water. This comprehensive literature review serves to characterize polydactylous SCCNU and distinguish the differences in its characteristics to improve diagnosis and clinical recognition.

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