Squamous cell carcinoma of the nail bed: a case report

Abstract

Squamous cell carcinoma of the nail bed is rare and commonly diagnosed late. Presentation is not specific and diagnosis rests on biopsy of the lesion. This condition can be easily misdiagnosed, especially if there is preceding trauma. We are also reporting such case involving the thumb. A 70 years old male patient presented at OPD with complaints of pain and ulcer over left thumb since last 4 months. Patients had lost his thumb nail 6 month back and since then was treated on Ayurvedic treatment. Patient does not give a history of trauma. Biopsy of the ulcer revealed Squamous Cell Carcinoma. His X-ray did not reveal any infiltration and hence a distal phalanx amputation of thumb was performed. Patient had an uneventful post-operative course and on 9 months follow up showed no recurrence. Rare still subungual squamous cell carcinoma should be considered early in lesions around the nail that fail to resolve after adequate conservative management. Early detection helps change surgical treatment from amputation to more preserving techniques like Moh’s or wide local flap reconstruction.