Squamous cell carcinoma of the nail unit: a retrospective review of 19 cases in Asia and comparative review of Western literature.

Abstract

Reports regarding squamous cell carcinoma of the nail unit (SCCnu) are rare in Asia. To investigate the features of SCCnu in the Asian population. We performed a retrospective review of patients diagnosed with SCCnu at our institution between 2012 and 2017. Nineteen cases were included. Thirteen patients were male (68.4%). The fingers were most frequently affected (73.7%). Mean delay to diagnosis was 62.4 months. Misdiagnosis rate was high (78.9%). Frequent clinical features were subungual tumor, subungual hyperkeratosis, nail dystrophy, ulcer, and nail loss. The majority of cases were invasive SCC in 15 cases (78.9%), while SCC in situ was found in four cases (21.1%). Local recurrence was detected in two cases (10.5%) following surgical resection. However, distant metastasis was not reported. This study provides data of 19 SCCnu cases in Asia. Clinical characteristics of SCCnu in this study were similar to those of reports from Western countries. However, we found a higher frequency of more invasive cases and longer delay to diagnosis in our study; this advocates the need for greater attention on nail disorders among healthcare providers, particularly in Asia.