Background: Squamous cell carcinoma (SCC) of the nail unit, known as the subungual region, and of the plantar foot is rare but often misdiagnosed due to its similar appearance to verruca, a common wart. The delayed diagnosis and treatment of SCC in the subungual and plantar foot leads to poorer outcomes. Human papillomavirus (HPV), and specifically the oncogenic potential of particular strains, influences SCC pathogenesis, progression, and treatment response. Methods: This review aims to address the current state of knowledge as well as deficits associated with clinical treatment of SCC in two anatomically challenging locations: verrucous carcinoma (VC), a variant of SCC that affects the plantar foot, and subungual SCC. Articles reviewed were evaluated based on date of publication, quality, and originality. Additionally, articles published after 2015 were given preferential consideration. Results: This review highlights considerations to reduce diagnostic delays and improve patient outcomes when considering two uncommon cutaneous malignancies. Conclusions: We recognize that misdiagnosis poses a barrier in the treatment of both plantar VC and subungual SCC. As such, we identify pertinent clinical pearls to assist in accurate identification and treatment of SCC in these locations. Lastly, we address the role of HPV and the microbiome in the pathogenesis of SCC to improve treatment efficacy.
背景：甲单位（即甲下区域）和足底鳞状细胞癌（SCC）较为罕见，但由于其外观与常见疣（即寻常疣）相似，常被误诊。甲下和足底鳞状细胞癌的延迟诊断与治疗会导致更差的预后。人乳头瘤病毒（HPV），特别是特定型别的致癌潜力，影响着鳞状细胞癌的发病机制、进展及治疗反应。 方法：本综述旨在探讨两个解剖结构复杂部位——影响足底的疣状癌（VC，鳞状细胞癌的一种亚型）和甲下鳞状细胞癌——的临床治疗相关知识现状及不足。所评阅文献根据发表时间、质量和原创性进行评估。此外，优先考虑了2015年后发表的文章。 结果：本综述重点提出了在诊断两种罕见皮肤恶性肿瘤时减少诊断延迟、改善患者预后的关键考量。 结论：我们认识到误诊是足底疣状癌和甲下鳞状细胞癌治疗中的主要障碍。因此，我们总结了相关的临床要点，以协助准确识别和治疗这些部位的鳞状细胞癌。最后，我们探讨了HPV和微生物组在鳞状细胞癌发病机制中的作用，以提高治疗疗效。
肿瘤(癌症)患者之家