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BACKGROUND: Skin cancers of the hand are uncommon and poorly documented. The objective of this study was to review a large cohort of patients with hand skin malignancies to determine tumor characteristics, management techniques, and outcomes. METHODS: A retrospective review of consecutive patients with surgically excised primary cutaneous hand malignancies at the John Radcliffe Hospital between 1993 and 2010 was performed. Records were reviewed to determine tumor characteristics, demographics, and management details. Outcome parameters included margins and completeness of excision, recurrence, metastatic spread, and survival. RESULTS: A total of 407 patients (65.8 percent male; mean age, 72.2 ± 0.7 yr) presented with 541 primary cutaneous hand malignancies and were followed up for a mean period of 24 months. Half the cohort had previous skin cancers and almost one in five developed further hand skin cancers. Squamous cell carcinoma comprised 78.0 percent, basal cell carcinoma 11.3 percent, and melanoma 3.9 percent of cases. Incidence was highest on the dorsum of the hand. Surgical margins were proportionate to tumor size, and most defects required soft-tissue reconstruction. Recurrence was uncommon in melanoma and rare in squamous and basal cell carcinomas. Lymph node metastasis and death were rare in patients with squamous cell carcinoma but relatively common in those with melanoma. CONCLUSIONS: Squamous cell carcinomas are the most common skin malignancy of the hand, frequently require soft-tissue reconstruction, and those occurring in the web spaces or on the dorsum of the proximal phalanges are more sinister malignancies with a greater propensity for metastatic spread. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, IV.

Original publication

DOI

10.1097/PRS.0b013e31824ecc58

Type

Conference paper

Publication Date

06/2012

Volume

129

Pages

1329 - 1336

Keywords

Age Factors, Aged, Carcinoma, Basal Cell, Carcinoma, Squamous Cell, Female, Follow-Up Studies, Hand, Humans, Incidence, Male, Retrospective Studies, Sex Distribution, Skin Neoplasms, Survival Rate, Time Factors, United Kingdom