Evaluating Dermoscopic Features of Nail Unit Squamous Cell Carcinoma: A Systematic Review and Sub-Analysis
Year: 2025
Type: review
Study design: Systematic Review
Abstract: Introduction: The diagnosis of nail unit squamous cell carcinoma (nSCC) remains challenging due to variable clinical presentations and nonspecific features. Dermoscopy offers a promising noninvasive adjunct to improve diagnostic accuracy, but dermoscopic features of nSCC are not well standardized nor summarized. Methods: We systematically reviewed dermoscopic features of keratinocyte-derived nail tumors to identify structures and patterns that differentiate nSCC from other lesions. Databases were searched from inception to March 2025. Studies reporting dermoscopic structures/patterns of benign and malignant keratinocyte-derived nail tumors, and onychomatricoma, were included. A sub-analysis assessed the diagnostic performance of specific features in differentiating nSCC from other keratinocyte-derived nail tumors. Results: From 1,159 articles screened, 83 studies met inclusion criteria, with 10 distinct nail tumors identified. Features such as heterogeneous and brown longitudinal melanonychia, white/yellow scale, structureless areas, glomerular vessels, and ulceration were more frequently reported in nSCC. In a sub-analysis of diagnostic value of specific dermoscopic features, subungual hyperkeratosis was significantly associated with nSCC compared to onychomatricoma. Conclusions: While underscoring ongoing diagnostic challenges of nSCC, this study also provides a framework for future prospective multicenter research aiming to establish reliable, standardized dermoscopic criteria. Such efforts are essential to improve early detection and enhance patient outcomes for those affected by nSCC.
Source: Skin Appendage Disorders
DOI: 10.1159/000550020
Authors: Lea Tordjman, Peyton V. Warp, Camille Robinson-Pinkney, Brian Morrison
Institution: University of Miami
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7114986484