Onycholemmal Carcinoma: a Rare, Specific Squamous Cell Malignancy

Abstract

We report a case of onycholemmal carcinoma in a 70-year-old lady who presented with a histology report of squamous cell carcinoma detected in a specimen obtained 3 months earlier upon excision of a small lesion with 2 mm margins at the tip of index finger terminal phalanx just under the nail edge. Thus, to achieve adequate oncological resection, excision of the nail and its bed with shaving off of the periosteum of the terminal phalanx was done. The histology report of the excised tissue was that of onycholemmal carcinoma of the right index finger without clear demarcation of margins; hence, the patient was taken up for disarticulation at the proximal interphalangeal joint of the affected index finger. Onycholemmal carcinoma is a rare, underdiagnosed condition for which multiple approaches including wide excision have been used but definitive management remains to be uniformly accepted and established.