Squamous Cell Carcinoma of the Nail Unit: A Clinical Histopathologic Study and a Proposal for Classification.

BACKGROUND

There is no consensus on the classification, grading, and the treatment of nail squamous cell carcinoma (NSCC).

OBJECTIVE

The aim of the study was to propose a possible classification of NSCC.

MATERIALS AND

METHODS

Nail squamous cell carcinoma referred from January 2006 till December 2014 was included. On the basis of the clinical presentation, patients with NSCC were divided in 2 groups. Group A tumors presented as nodular or ulcerated masses of the nail bed, whereas Group B tumors presented as hyperkeratotic bands. In these 2 groups, differences in proportions (sex, histopathologic grading, and treatment performed) were evaluated with the chi-square test.

RESULTS

Forty-one NSCCs were included. The groups of NSCC differed regarding: (1) the age of the patients, (2) histopathology, and (3) surgical approach.

CONCLUSION

Nail squamous cell carcinomas may originate from 2 different epithelia, presenting a diverse clinical behavior. The correct identification and diagnosis of each subgroup of NSCC could be helpful in standardizing management of this tumor. Future studies considering human papillomavirus subtyping and including a major number of tumors should be performed to confirm or reject the authors' hypothesis.

LIMITATIONS: This is a retrospective study, presenting the data and the experience of a single institute.