# Periungual squamous cell carcinoma in childhood: a case report

## TL;DR

A rare case of periungual squamous cell carcinoma in an 11-year-old girl is reported, highlighting the need for vigilance in diagnosing skin cancer in children.

## Contribution

This case report adds to the limited literature on pediatric squamous cell carcinoma and emphasizes the diagnostic challenges of pigmented SCC in acral regions.

## Key findings

- An 11-year-old girl presented with a periungual pigmented lesion diagnosed as Pigmented Squamous Cell Carcinoma in situ.
- The case highlights the importance of considering malignancy in pediatric patients with atypical skin lesions.
- Treatment included excision, nail apparatus removal, adjuvant imiquimod, and skin grafting.

## Abstract

Bowen's disease (BD) is the second most common skin cancer worldwide, often linked to sun exposure, arsenic, and immunosuppression. Though rare in pediatrics, it is the third most common pediatric skin cancer, associated with conditions like albinism and immunosuppression. Recent years have seen an increase in Squamous Cell Carcinoma (SCC) cases among children, potentially related to immunosuppression and human papillomavirus (HPV) infection, particularly subtype 16. We present the case of an 11-year-old girl from Mexico City with a five-year history of a slowly growing, asymptomatic, dark-brown plaque on the periungual region of her right hand. Histopathological examination revealed Pigmented Squamous Cell Carcinoma in situ. The lesion was treated with excision, nail apparatus removal, and adjuvant 5% imiquimod cream, followed by skin grafting. This case underscores the importance of considering malignancy in pediatric patients, particularly with atypical presentations in acral sites, and highlights the diagnostic challenges of pigmented SCC.