(BMJ)—A 67-yo man presented w/ 2 yrs of swelling, pain, and drainage from his L ring finger. Exam: swelling, foul-smelling discharge from multiple sinuses. XR: soft tissue swelling w/ thinning of midphalanx. MRI: soft tissue lesion. What is the dx?
Malignant melanoma
Cutaneous squamous cell carcinoma
Chronic mucocutaneous candidiasis
Blastomycosis
Pyoderma gangrenosum
You are correct. A cutaneous squamous cell carcinoma was identified on excision biopsy. This is the second-most-common skin cancer but is rarely seen in the fingers. Neoplasia in soft tissue swelling may mimic infection. No evidence of early local or distant recurrence was seen on f/u.