Moraga Richard, Hopkins Theresa, Sclamberg Gracie S, Gallo Elisa S
Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.
SUNY Downstate Medical School, Brooklyn, NY 11203, USA.
Cancers (Basel). 2025 Sep 16;17(18):3029. doi: 10.3390/cancers17183029.
Squamous cell carcinoma (SCC) of the nail unit, known as the subungual region, and of the plantar foot is rare but often misdiagnosed due to its similar appearance to verruca, a common wart. The delayed diagnosis and treatment of SCC in the subungual and plantar foot leads to poorer outcomes. Human papillomavirus (HPV), and specifically the oncogenic potential of particular strains, influences SCC pathogenesis, progression, and treatment response.
This review aims to address the current state of knowledge as well as deficits associated with clinical treatment of SCC in two anatomically challenging locations: verrucous carcinoma (VC), a variant of SCC that affects the plantar foot, and subungual SCC. Articles reviewed were evaluated based on date of publication, quality, and originality. Additionally, articles published after 2015 were given preferential consideration.
This review highlights considerations to reduce diagnostic delays and improve patient outcomes when considering two uncommon cutaneous malignancies.
We recognize that misdiagnosis poses a barrier in the treatment of both plantar VC and subungual SCC. As such, we identify pertinent clinical pearls to assist in accurate identification and treatment of SCC in these locations. Lastly, we address the role of HPV and the microbiome in the pathogenesis of SCC to improve treatment efficacy.
甲单位（即甲下区域）和足底的鳞状细胞癌（SCC）较为罕见，但因其外观与常见的疣状表皮发育不良相似，常被误诊。甲下和足底SCC的延迟诊断和治疗会导致较差的预后。人乳头瘤病毒（HPV），尤其是特定毒株的致癌潜力，会影响SCC的发病机制、进展和治疗反应。
本综述旨在阐述两个解剖结构具有挑战性部位的SCC临床治疗相关的现有知识状况及不足之处，这两个部位分别是疣状癌（VC，一种影响足底的SCC变体）和甲下SCC。所综述的文章根据发表日期、质量和原创性进行评估。此外，优先考虑2015年后发表的文章。
本综述强调了在考虑两种罕见皮肤恶性肿瘤时减少诊断延迟并改善患者预后的注意事项。
我们认识到误诊是足底VC和甲下SCC治疗中的一个障碍。因此，我们确定了相关的临床要点，以协助准确识别和治疗这些部位的SCC。最后，我们阐述了HPV和微生物群在SCC发病机制中的作用，以提高治疗效果。
