Journal of Clinical and Aesthetic Dermatology

AUG 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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47 JCAD JouRnal oF CliniCal and aesthetiC deRMatology august 2017 • Volume 10 • number 8 C a s e r e P o r t biopsy to exclude cancer. although the initial specimen did not show wart or viral changes a ssociated with the sCC, the excised residual tumor did reveal viral changes. treatment. the approach to therapy for sCC of the ventral digits is derived from the limited number of reported patients (table 3). 5–14,16–18,20,21,23–26,29 unsuccessful modalities were often described in individuals with advanced tumors. many of the successfully treated patients—albeit some whose cancer diagnosis was signiucantly delayed—had amputation of the entire asected digit or en bloc removal of the digit at the joint proximal to the gross tumor involvement. some of the patients with more extensive preoperative tumors also received postoperative tazarotene, 12 chemotherapy, 1 2 or radiation therapy 2 5 to prevent recurrence. local excision of the tumor, without the underlying tendons and bone, also provided eradication of the cancer. our patient's malignancy required uve stages of mohs surgery to completely remove the tumor based on microscopic evaluation of the tissue margins. His cancer demonstrates that unsuspected subclinical tumor extension and adjacent tumor invasion may be present in patients who have sCC of their ventral digits. alternative treatments for patients with less extensive sCC in situ of their palmar digits included photodynamic therapy 6,10,21 and ablation using the carbon dioxide laser. 7 Response to therapy. most of the patients with sCC in situ or sCC of a ventral digit— regardless of size or initial delay in diagnosis—have a favorable outcome. 5–10,12–14,17,18,20,21,23–25,29 simple or more extensive resection of the tumor is usually curative. subsequent local recurrence 16 or metastases 16,26 of the tumor are uncommon. ConClusion sCC of the ventral digits is rare. risk factors that may be associated with tumor development at this location in these individuals include local or systemic carcinogen exposure, congenital conditions, s uppressed host immunity, coincident bacterial or viral infection, local radiation exposure, and trauma to the affected digit. Chronic dermatitis, epidermoid cyst, infection, keratoderma, melanoma, and/or verrucae are tumors and conditions that not only mimic but also can coincidentally occur at the site of palmar digit sCC. the mainstay of therapy is surgical removal of the cancer. this has been successfully per formed by amputation of all or par t of the affected digit or excision of the cutaneous malignancy with subsequent evaluation of margins to ensure complete removal of the tumor. the prognosis for patients with sCC of the ventral digits—regardless of the occasional delay in diagnosis, large tumor size, or both—is usually favorable following treatment of the cancer. ReFeRenCes 1. nordin P, stenquist b, Hansson bG. Joint occurrence of human papillomavirus type 16 Dna in bowen's disease on a finger and in dysplasia of the vulva and the uterine cer vix. [letter] Br J Dermatol. 1994;131:740. 2. alam m, Caldwell Jb, eliezri YD. Human papillomavirus-associated digital squamous cell carcinoma: literature review and repor t of 21 new cases. J Am Acad Dermatol. 2003;48:385–393. 3. Gormley rH, Groft Cm, miller CJ, Kovarik Cl. Digital squamous cell carcinoma and association with diverse high-risk human papillomavirus types. J Am Acad Dermatol. 2011;64:981–985. 4. lecer f P, richer t b, theunis a, andre J. a retrospective study of squamous cell carcinoma of the nail unit diagnosed in a belgian general hospital over a 15-year period. J Am Acad Dermatol. 2013;69:253–261. 5. Firooz a, Farsi n, rashighi-Firoozabadi m, Gorouhi F. Pigmented bowen's disease of the finger mimicking malignant melanoma. Arch Iranian Med. 2007;10:255–257. 6. Wong Wt, sheu H-m, lee JY-Y, Fletcher rJ. Photodynamic therapy for bowen's disease (squamous cell carcinoma in situ) of the digit. Dermatol Surg. 2001;27:452–456. 7. tantikun n. treatment of bowen's disease of the digit with carbon dioxide laser. J Am Acad Dermatol. 2000;43:1080–1083. 8. bonfiglio m, landas s. Case repor t 640: well-differentiated, primar y squamous cell carcinoma of the thumb. Skeletal Radiol. 1990;19:599–601. 9. Chaimers rl, ikram s, schreuder F. multiple digital squamous cell carcinoma due to 'soluble-oil'. [clinical tip] J Plast Reconstr Aesthet Surg. 2008;10:1147. 10. souza Cs, Felicio lba, bentley mV, et al. topical photodynamic therapy for bowen's disease of the digit in epidermolysis bullosa. [letter]. Br J Dermatol. 2005;153:672–674. 11. Hosokawa K, Yoshitatsu s, Kakibuchi m, et al. simultaneous manifestations of squamous cell carcinoma in identical twins with epidermolysis bullosa. Plast Reconstr Surg. 1998;102:448–449. 12. sekar sC, srinivas Cr. Huriez syndrome. Indian J Dermatol Venereol Leprol. 2008;74:409–410. 13. Watanabe e, takai t, ichihashi m, uede m. a nonfamilial Japanese case of Huriez syndrome: p53 expression in squamous cell carcinoma. Dermatology. 2003;207:82–84. 14. lam Wl, Hardwicke J, laitung G. squamous cell carcinoma in bilateral untreated syndactyly. Scan J Plast Surg Hand Surg. 2009;43:294–295. 15. ibe mm, Kawase m, ishiji t, Kamide r, niimura m. a cardiac allograft recipient with bowen's disease on a finger and concurrent perianal bowenoid papulosis. J

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