BACKGROUND:
Squamous cell carcinoma of the palmar digits is rare. PURPOSE: The authors describe a man with
squamous cell carcinoma of the pulp of his left fourth finger, and review the risk factors that may be associated with
squamous cell carcinoma development on the ventral digits of the hand. the authors also summarize the clinical differential diagnoses and treatment of
squamous cell carcinoma at this location. METHODS: the authors retrospectively reviewed the literature using PubMed and searched for the following terms:
squamous cell carcinoma,
squamous cell carcinoma in situ, finger, thumb, palmar, and ventral. Papers were critically evaluated and their cited references reviewed. RESULTS: Skin biopsy established the patient's diagnosis. His
tumor was excised using Mohs technique with microscopic examination of the tissue margins; viral changes were noted in the keratinocytes. Local or systemic
carcinogen exposure, congenital conditions, suppressed host immunity, coincidental bacterial or
viral infection, local radiation exposure, and
trauma to the affected digit are risk factors associated with the development of palmar digit
squamous cell carcinoma. The clinical differential diagnoses of
squamous cell carcinoma on the ventral digits include chronic
dermatitis and keratoderma,
epidermoid cyst,
infection,
melanoma, and verrucae. Successful treatment involves removal of the
tumor; this is usually accomplished by surgical excision of the
tumor, which may include some or all of the affected digit. CONCLUSIONS: The diagnosis of
squamous cell carcinoma of the ventral hand digits is often not initially suspected by the patient and/or the clinician. However, despite the occasional delay in diagnosis or subsequent large
tumor size, the prognosis for these patients is usually favorable following adequate treatment of the
cancer.