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a-Subungual keratoacanthoma. Skin biopsy: Large crater-like squamoproliferative lesion connected to the epidermis (H&E, 40x).
Source publication
O queratoacantoma subungueal é uma variante rara do queratoacantoma, caracterizada por um comportamento mais agressivo. Os autores apresentam o caso de um homem de 49 anos que recorre à consulta por nódulo exofítico duro localizado no leito ungueal do primeiro dedo do pé esquerdo, com cerca de 2 cm de diâmetro, hiperqueratósico, amarelado, com 1 an...
Context in source publication
Context 1
... incisional biopsy was performed and histopathology revealed a large crateriform squamoproliferative lesion (Fig. 3a), connected to the epidermis that consisted of lobules and nests of glassy epithelium with numerous dyskeratotic cells, very little cytological atypia and low mitotic activity (Fig. 3b). The lesion extended deep into the dermis and was associated with fibrosis and focal but moderate lichenoid tissue reaction. Lymphovascular, perineural ...
Citations
... The cause is still unknown. Association with trauma or exposure to carcinogenic chemicals has been linked to the development of SUKA, as well as eczema, psoriasis, atopic dermatitis, xeroderma pigmentosum, and incontinentia pigmenti [7]. ...
Introduction:
Keratoacanthoma (KA) is a group of tumors of epidermal origin with controversial nature. Subungual keratoacanthoma (SUKA) is a rare and destructive variant with more aggressive behavior. SUKA appears as a rapidly growing, painful tumor beneath the nail plate that rapidly progresses to a mass that can measure up to 2 cm. The toe location is unusual. The diagnosis must be made based on the correlation of clinical, radiological, and histopathological findings.
Case presentation:
We present two cases of patients diagnosed with SUKAs with different clinical presentations which ranged from very typical to uncommon one. Both cases were treated with simple excision without recurrences.
Conclusion:
SUKA is a rare subungual tumor. Nail bed location represents a more difficult diagnostic challenge. SUKA should be suspected in the context of persistent and progressive pain on a finger or toe, once more frequent painful tumors have been ruled out.
Tumour-like lesions of bone pose diagnostic difficulty in differentiating from tumours. The entities included in this chapter are Paget disease, osteomyelitis, hamartoma, mastocytosis, hyperparathyroidism, osteopetrosis, etc.
