Squamous carcinoma of the nail bed. A case report.

Primary carcinoma of the nail bed is a rare occurrence, and all cases yet reported arose in the fingers. Although often masked by chronic disease of the overlying nail or surrounding tissues, the lesion is slow-growing and spread of the tumour before diagnosis is rare. A case of primary squamous carcinoma of the nail bed of the right hallux, in which spread to regional lymph nodes had occurred, is reported. The tumour was treated by amputation of the toe, block dissection of the regional lymph nodes and adjuvant bleomycin chemotherapy. These advanced lesions are so rare that there is no standardized therapeutic regimen, but we believe that ablative surgery with adjuvant chemotherapy affords the best chance of cure. We recommend that biopsies be performed in all cases of recurrent and persistent disease of the nail bed so that early diagnosis and treatment can be instituted while the tumour is confined to its primary site.