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 4. A 75-year-old female with a background of scleroderma, Raynaud's disease, hypothyroidism and type 2 diabetes was referred via her rheumatologist for pain and onycholysis of the right thumb. On examination the underlying nail bed was unremarkable aside from some variation in colour; there was no axillary lymphadenopathy. Surprisingly a biopsy of the nail bed revealed a 3.3mm thick moderately differentiated SCC. Following MDT discussion, the patient underwent amputation of the distal phalanx under local anaesthetic. The stump healed well and has showed no evidence of recurrence or metastasis at last clinic review 22 months later ().