Case 2. A 71-year-old female was referred from Dermatology with a 5-month history of a fixated swelling on the right index finger and an ulcerated lesion involving the second webspace; a biopsy showed this to be a well differentiated SCC. There was no clinical or radiological evidence of lymphatic or metastatic spread. The patient underwent amputation of the right index finger at the level of the metacarpal phalangeal joint (MCPJ) under general anaesthesia. Histological analysis reported a completely excised moderately differentiated SCC measuring 9.9mm thick. She was discharged home the same day and 48 months later has had no sign of recurrence or metastasis ().
Case 6. An 84-year-old female presented to the Plastic Surgery Department following a non-healing ulcer on her right hand, wrist and forearm. She sustained a hot oil scald to both upper limbs at the age of 23 whilst living in Kenya. The burns were excised and resurfaced with a split thickness skin graft. Unfortunately, she developed an unstable scar on the right upper limb since her injury and has been managed with dressings and antibiotics. Skin biopsies were performed intermittently over the years which revealed inflammatory changes only, however, 6 years since the last skin biopsy, a 7mm thick well differentiated SCC was reported. The patient had one palpable lymph node in the right axilla however fine needle aspiration cytology and CT showed no evidence of metastasis. Due to the extensive nature of ulceration and poor skin quality of the adjacent areas it was decided that amputation of the hand at the level of the mid forearm was most appropriate. She has healed well and has showed no sign of recurrence nor metastasis 1 month post-operatively ().