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BMJ Case Reports 2017; doi:10.1136/bcr-2017-219715
  • Rare disease
  • CASE REPORT

Marjolin’s squamous cell carcinoma of the hallux following recurrent ingrown toenail infections

  1. Anthony Perera
  1. Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, UK
  1. Correspondence to Mr Wahid Abdul, abdulw{at}cardiff.ac.uk
  • Accepted 3 June 2017
  • Published 14 June 2017

Summary

Marjolin’s squamous cell carcinoma (SCC) affecting the toe is rare. Due to resemblance with benign conditions it can often result in misdiagnosis. We report a case of Marjolin’s SCC affecting the proximal hallux in a patient with recurrent ingrown toenail infections. A 58-year-old woman with a background of wedge resections for ingrown toenail and distal phalanx amputation for osteomyelitis presented with pain and hyperkeratotic raised ulcer around the proximal phalanx. MRI scan revealed soft tissue mass infiltrating the proximal phalanx with biopsies confirming a SCC. The patient underwent first ray amputation and made a good clinical recovery and remains disease free. Due to clinical similarities with benign conditions, awareness of Marjolin’s SCC as a potential diagnosis when treating patients with recurrent ingrown toenail is imperative. We recommend patients with recurrent ingrown toenail or ulceration with a background of chronic infection have biopsies performed to exclude potential malignancy.

Footnotes

  • Contributors WA was responsible for writing the paper, collecting photographs, and radiographs. BJON was responsible for editing the paper and literature review. AP was responsible for planning and conceptualisation of the paper, and is the consultant treating this particular patient.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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