Epidermoid carcinoma

The term 'epidermoid carcinoma' denotes both ungual Bowen's disease and squamous cell carcinoma. Commonly originating from the lateral sulcus, Bowen's disease slowly spreads under and around the nail. Histologically, all changes typical of Bowen's disease of the skin are seen: loss of orderly architecture and polarity of basal cells, atypical nuclei, pathological mitoses, some giant cells, dyskeratoses, often vacuolization, and even clear cells. After decades the lesion develops into invasive squamous cell carcinoma, which, however, may also develop without prior bowenoid changes.

Malignant onycholemmal cyst is probably a particular form of Bowen's disease, as was seen in a case in which the cyst, after incomplete removal, rapidly showed the features of typical squamous cell carcinoma (author's unpublished observation).

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