This lesion, partially hidden under the nail, had been present and slowly growing for 10 years.
Rarely, squamous cell carcinoma (SCC) may occur in the periungual/subungual area. See also squamous cell carcinoma. HPV has been found in up to 80% of lesions and it has been theorized that these lesions in fact may have been verruca for many years and only subsequently underwent malignant change. HPV 16 is most common.
A hyperkeratotic or verrucous, periungual, or subungual lesion treated for years as a verruca is characteristic. Pain, swelling, inflammation, redness, bleeding, and nail deformation are common. Men 50-80 years of age and a single finger are most typical.
Some have recommended amputation, however, these SCCs tend to be less aggressive and most recommended Mohs surgery. Radiation therapy is a good alternative for patients who are poor surgical candidates.
JAAD August 2013 Volume 69, Issue 2, Pages 253–261.e1
SCC Periungual from JAAD September 2014 Volume 71, Issue 3, Pages e65–e67
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