Subungual Squamous Cell Carcinoma of the Left Fifth Toe: A Case Report

PURPOSE: Subungual squamous cell carcinoma is a very rare malignant tumor of the digitus especially in toe making it very difficult to differentiate from tinea unguium, verruca vulgaris, eczema, pyogenic granuloma, and malignant melanoma due to their clinical similarities. Therefore this article reports on subungual squamous cell carcinoma of left 5th toe. METHODS: A patient visited at our hospital due to pain and incurable inflammation on left 5th toe with no improvement for four months. Despite of antibiotics and dressing for a week, treatment was ineffective. After excisional biopsy, he was diagnosed with subungual squamous cell carcinoma. And ray amputation and prophylactic inguinal lymph node dissection was done. RESULTS: The biopsy was showed irregular cells made up of anaplastic and squamous cells in the dermis and epidermis. And the inguinal lymph node showed no metastasis. The patient had been treated without significant complications or recurrence for a year. CONCLUSION: This article emphasizes the need of diagnostic biopsy on the subungual lesions that have resistance to the conventional treatments. And if that is subungual squamous cell carcinoma, complete resection of the lesion and prophylactic inguinal lymph node dissection is essential.

Clinical Applications of Endoscopic-Assisted Open Reduction and Internal Fixation of Subcondylar Fractures

PURPOSE: The management of fractures of mandibular subcondyle continues to be controversial over open and closed treatment. The purpose of this article is to explain the endoscopic assisted open reduction and internal fixation and minimize the controversy. METHODS: For nine patients, mandibular subcondylar fracture were reduced and fixed by using intraoral endoscopic-assisted open reduction and internal fixation and were followed up for 14 - 24 months after the surgery. RESULTS: Eight patients of mandibular subcondylar fracture had been treated without significant complications. One patient, whose malocclusion had been remained, was recovered normal occlusion by maxillomandibular fixation using intermaxillary screws for 3 weeks. CONCLUSION: The advantages of endoscopic-assisted open reduction and internal fixation are direct visualization, accurate fracture repair, minimized scar, decreased morbidity. And maxillomandibular fixation is not needed when it is done by accurate reduction and rigid fixation with one miniplate in the region of subcondylar fracture. With the above consideration, endoscopic-assisted open reduction and internal fixation can be considered as one of the best treatments for subcondylar fracture of the mandible.