Rapidly enlarging growth of the proximal nail fold

BACKGROUND. Squamous cell carcinoma (SCC) of the nail unit is a rare but often underappreciated neoplasm. Treatment can be delayed due to confusion with paronychia and verruca. Infection with human papilloma virus (HPV) has been associated with this malignancy. OBJECTIVE. To describe the development of a superficially invasive SCC of the proximal nail fold in a patient infected with HIV, to report the association of a previously unrecognized HPV genotype, and to review key etiologic, diagnostic, and therapeutic points as related to SCC of the proximal nail fold. RESULTS. This is the first report of HPV 26 coinfection in monogamous sexual partners, both of whom are HIV infected and have demonstrated lesions of malignant degeneration consistent with SCC. CONCLUSION. SCC must be considered in the differential diagnosis of nail fold neoplasm. An immunocompromised condition such as HIV/AIDS may predispose to malignant degeneration of lesions caused by infection with HPV.