Case 5. A 78-year-old female presented with a 4-month history of a crusted nail bed lesion and nail plate dystrophy of the right index finger; there was no axillary lymphadenopathy. She also suffered from type 2 diabetes, gout and hypertension. Histology revealed a moderately differentiated SCC arising from bowenoid dysplasia. Following MDT discussion, she underwent right index finger amputation through the DIPJ using a volar skin flap for coverage under local anaesthetic. The 2.3 mm thick SCC was completely excised however Bowen's disease was present at the lateral margin and was therefore treated topically. She has had no sign of recurrence or metastasis for 14 months.
Case 3. A 67-year-old male was referred by a Dermatologist with a 2-month history of biopsy proven squamous cell carcinoma present on each hand. The lesion on the right hand involved the middle finger and third webspace and the lesion on the left hand involved only the dorsum. There was no sign of axillary lymphadenopathy bilaterally. This gentleman suffered from COPD, had a tracheostomy in situ for previous T4 vocal cord tumour and was a heavy smoker.\nHe underwent amputation of the right middle and ring fingers at the level of the MCPJ and was reconstructed using a fillet flap from ring finger. Histology reported a moderately differentiated, 17 mm thick SCC. His recovery was unmarkable and recurrence was not detected within the first post-operative year. Unfortunately, he died following sequelae of the vocal cord tumour ().