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Singapore Med J. 2008 Mar;49(3):e76-7.

Subungual squamous cell carcinoma masquerading as a melanotic macule.

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  • 1National Skin Centre, 1 Mandalay Road, Singapore 308205.


Subungual squamous cell carcinoma is a rare condition. Diagnosis is often delayed because it presents with minimal nail changes and mimics a number of benign nail conditions. We report a 43-year-old Chinese man who presented with a three-year history of an indolent melanotic macule of the fingernail. Histology from a punch biopsy revealed a well-differentiated squamous cell carcinoma. Wide local excision with full thickness skin grafting was performed. Physicians should have a high index of clinical suspicion as early nail biopsy and prompt tumour clearance can preserve joint function.

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