Abstract
Mohs surgery for a malignancy in the periungual and subungual location is advantageous because it is a tissue-sparing technique that preserves maximum function and normal appearance. Traditional surgical treatment for such tumors is wide local excision and closure; in some cases, amputation of the digit is considered. The amount of tissue removed with these standard surgical treatments may be quite debilitating for the patient. Often, Mohs surgery will preserve a significant amount of nail matrix so that an almost normal-appearing nail regrows.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Zaiac MN, Weiss E. Mohs micrographic surgery of the nail unit and squamous cell carcinoma. Dermatol Surg. 2001;27:246–51.
Goldminz D, Bennett RG. Mohs micrographic surgery of the nail unit. J Dermatol Surg Oncol. 1992;18(8):721–6.
Bennett RG. Fundamentals of cutaneous surgery. St. Louis: Mosby; 1988. A. p134, B. p134.
Salasche SJ, Garland LD. Tumors of the nail. Dermatol Clin. 1985;3:501–19.
Virgili A, Rosaria Zampino M, Bacilieri S, Bettoli V, Chiarelli M. Squamous cell carcinoma of the nail bed: a rare disease or only misdiagnosed? Acta Derm Venereol. 2001;81:306–7.
Baran RL, Gormley DE. Polydactylous disease of the nail. J Am Acad Dermatol. 1987;17:201–4.
Porembski MA, Rayan GM. Subungual carcinomas in multiple digits. J Hand Surg Eur Vol. 2007;32(5):547–9.
Peterson SR, Layton EG, Joseph AK. Squamous cell carcinoma of the nail unit with evidence of bony involvement: a multidisciplinary approach to resection and reconstruction. Dermatol Surg. 2004;30(2 Pt 1):218–21.
de Berker DA, Dahl MG, Malcolm AJ, Lawrence CM. Micrographic surgery for subungual squamous cell carcinoma. Br J Plast Surg. 1996;49(6):414–9.
Conill C, Verger E, Vilalta A, Palou J. Case report: squamous cell carcinoma of the nail bed. Br J Radiol. 1993;66:163–4.
Yaparpalvi R, Mahadevia PS, Gorla GR, Beitler JJ. Radiation therapy for the salvage of unresectable subungual squamous cell carcinoma. Dermatol Surg. 2003;29:294–6.
Wong TW, Sheu HM, Lee JY, Fletcher RJ. Photodynamic therapy for Bowen’s disease (squamous cell carcinoma in situ) of the digit. Dermatol Surg. 2001;27(5):452–6.
Goron KB, Garden JM, Robinson JK. Bowen’s disease of the distal digit: outcome of treatment with carbon dioxide laser vaporization. Dermatol Surg. 1996;22:723–8.
Lumpkin LR, Rosen T, Tschen JA. Subungual squamous cell carcinoma. J Am Acad Dermatol. 1984;11:735–8.
Baran RL, Simon C. Longitudinal melanonychia: a symptom of Bowen’s disease. J Am Acad Dermatol. 1988;18:1359.
Blessing K, Kernohan NM, Park KG. Subungual malignant melanoma: clinicopathological features of 100 cases. Histopathology. 1991;19:425–9.
Pack GT, Oropeza R. Subungual melanoma. Surg Gynecol Obstet. 1967;124:571–82.
Takematsu H, Obata M, Tomita Y, et al. Subungual melanoma: a clinicopathologic study of 16 Japanese cases. Cancer. 1985;55:2725–31.
Lingam MK, McKay AJ, Mackie RM, Aitchison T. Single-centre prospective study of isolated limb perfusion with melphalan in the treatment of subungual malignant melanoma. Br J Surg. 1995;82:1343–5.
James WD, Berger TG, Elston DM. Andrews’ diseases of the skin. 10th ed. Philadelphia: Saunders; 2006. 695, 859.
Scher RK, Daniel CR. Nails: therapy, diagnosis, surgery. Philadelphia: Saunders; 1990. p. 209.
Moehrle M, Metzger S, Schippert W, Garbe C, Rassner G, Breuninger H. “Functional” surgery in subungual melanoma. Dermatol Surg. 2003;29(4):366–74.
Moehrle M, Haefner HM. Is subungual melanoma related to trauma? Dermatology. 2002;204:259–61.
Green DP. Green’s operative hand surgery. 5th ed. Philadelphia: Elsevier/Churchill Livingstone; 2005. 2204pp.
Brodland DG. The treatment of nail apparatus melanoma with Mohs micrographic surgery. Dermatol Surg. 2001;26:269–73.
Do AN, Goleno K, Geisse JK. Mohs micrographic surgery and partial amputation preserving function and aesthetics in digits: case reports of invasive melanoma and digital dermatofibrosarcoma protuberans. Dermatol Surg. 2006;32(12):1516–21.
Herzinger T, Flaig M, Diederich R, Röcken M. Basal cell carcinoma of the toenail unit. J Am Acad Dermatol. 2003;48(2):277–8.
Martinelli PT, Cohen PR, Schulze KE, Dorsey KE, Nelson BR. Periungual basal cell carcinoma: case report and literature review. Dermatol Surg. 2006;32(2):320–3.
Guanna AL, Kolbusz R, Goldberg L. Basal cell carcinoma on the nailfold of the right thumb. Int J Dermatol. 1994;33:204–5.
Nelson LM, Hamilton CF. Primary carcinoma of the nail bed. Arch Dermatol. 1970;101:63–7.
Hoffman S. Basal cell carcinoma of the nail bed. Arch Dermatol. 1973;108:828.
Firoz B, Davis N, Goldberg LH. Local anesthesia using buffered 0.5% lidocaine with 1:200,000 epinephrine for tumors of the digits treated with Mohs micrographic surgery. J Am Acad Dermatol. 2009;61(4):639–43.
Ersek RA. Ischemic necrosis and elastic net bandages. Tex Med. 1982;78:47.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag London Limited
About this chapter
Cite this chapter
Chow, S., Bennett, R.G. (2012). Mohs Surgery for Periungual and Subungual Skin Cancer. In: Nouri, K. (eds) Mohs Micrographic Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-2152-7_28
Download citation
DOI: https://doi.org/10.1007/978-1-4471-2152-7_28
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-2151-0
Online ISBN: 978-1-4471-2152-7
eBook Packages: MedicineMedicine (R0)