Of the 110 patients with 117 cutaneous squamous cell carcinomas of the nail unit, only two tumors had local recurrence (2/117; 1.7%).
Clinical Pearls
This retrospective chart review included the largest single-institution cohort of cutaneous Squamous Cell Carcinomas of the nail unit treated with Mohs Micrographic Surgery.
Of the 110 patients with 117 cutaneous squamous cell carcinomas of the nail unit, only two tumors had local recurrence (2/117; 1.7%).
This study adds to the literature supporting the efficacy of Mohs surgery for cutaneous squamous cell carcinoma of the nail unit.
Discussion:
In this research letter published by Veerabagu et. al, the authors investigated the effectiveness of Mohs Micrographic Surgery (MMS) for cutaneous squamous cell carcinoma (cSCC) of the nail unit. Of note, the authors noted their study performed is the largest, single-institution cohort study investigating cSCC of the nail unit to date.
Using data from the University of Pennsylvania Department of Dermatology, the authors reviewed all cases of MMS-treated nail unit cSCC from 2001-2020. Local recurrence was determined through contacting patients by phone and chart review.
Through analysis of 101 patients with 117 nail unit cSCCs and cSCC in situs, the authors found a local recurrence rate of 1.7% (2/117). Dermatologists were the ones to find both these local recurrences, which occurred in immunocompromised transplant recipients.
Additionally, the authors found amputation with local volar flap was performed in 17.1% of these cases (20/117). Of these 20, disarticulation at the interphalangeal joint was performed in 12, while partial amputation of the distal phalanx and preservation of the interphalangeal joint and extensor tendon was performed in the other 8. While this study is limited in its single-institution and retrospective design, it provides valuable insight into the utility of MMS for cSCC of the nail unit.
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