06 March 2026
: Case report 
Multifocal Digital Squamous Cell Carcinoma With Sarcoma Differentiation: A Case Report
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction, Rare coexistence of disease or pathology
Yingling Xiang ADEF 1, Liuchang Tan ABCF 1*DOI: 10.12659/AJCR.951172
Am J Case Rep 2026; 27:e951172
Table 1 Clinical signs of carcinoma of nail unit.
| Clinical sign | L5 | L4 | L3 | L2 | R2 | R3 | R4 |
|---|---|---|---|---|---|---|---|
| Nail bed ulceration | − | +/− | + | + | + | + | +/− |
| Subungual tumor | +/− | +/− | + | + | + | + | + |
| Oozing | − | +/− | +/− | + | + | + | +/− |
| Foul odor | +/− | + | +/− | + | + | + | +/− |
| Squamous lesion | + | + | + | + | + | + | + |
| Subungual hyperkeratosis | + | + | + | + | + | + | + |
| Fingertip hyperkeratosis | + | + | + | + | + | + | + |
| Periungual hyperkeratosis | + | + | + | + | + | + | + |
| Pain | +/− | + | +/− | + | + | + | +/− |
| Total nail apparatus destruction | + | + | + | + | + | + | + |
| Pyogenic granuloma-like lesion | +/− | + | + | + | + | + | +/− |
| Prominent symptoms (+); absent features (−); equivocal findings (+/−); L2–5, the second to fifth digits of the left hand; R2–4, the second to fourth digits of the right hand. | |||||||