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Subungual squamous cell carcinoma mimicking chronic paronychia |
European Journal of Dermatology. Volume 10, Number 2, 149-50, March 2000, Votre diagnostic !
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 Free Article
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Author(s) : R. Betti, R. Vergani, E. Inselvini, E. Tolomio, C. Crosti |
Summary : A 83-year-old man presented to our clinic with an erythematous and infiltrative lesion on the lateral surface of the terminal phalanx of the little finger of the left hand. The lesion had developed in the last 3 months.
Physical examination showed a painless erythematous and infiltrative lesion on the lateral nail fold of the little finger and then extending to the entire finger. Blood was discharged from the ulcerative portion of the lesion. The lesion involved the lateral nail fold and there was destruction of the lateral portion of the nail and hyperkeratosis of the nail bed (Fig. 1).
The lesion had been treated for fungal infection (Terbinafina cp 250 mg, 1 cp/day for 2 weeks) without improvement.
X-rays, taken to rule out chronic osteomyelitis, showed a lytic lesion of the distal phalanx of the little finger. The bone cortical was eroded and the soft tissues were tumefied (Fig. 2).
A biopsy skin specimen revealed sheets of proliferating anaplastic keratinocytes that had invaded the dermis. The cells had pleomorphic hyperchromatic nuclei and prominent nucleoli. Dyskeratotic cells and abnormal mitoses were also present. The basement membrane was not discernible (Fig. 3). |
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