Chemosurgical excision of subungual squamous cell carcinoma.

Chemosurgery and wound healing by secondary intention is an excellent method of treatment for subungual carcinoma. It allows for complete ablation of the tumour with maximal preservation of tissue, eliminating the need for amputation, in the absence of bone involvement. As most nail bed carcinomas occur on the thumb, by avoiding distal phalanx amputation one can prevent considerable disability. Because chemosurgery traces out every infiltrating band of tumour, bone involvement can be accurately detected. Amputation, if necessary, could then be carried out to achieve cure. Despite the age of our patients (averaged age 64.6 years), all surgical sites healed well with good range of motion at the adjacent interphalangeal joint.