case_images: PMC11803895_01
case_images: Pre-operative appearance of finger pulp.
case_images: gr1.jpg
case_images: PMC11803895_01_gr1.jpg
case_images: f0005
case_images: Examination revealed a roughly 2 x 1 cm mobile, hyperkeratotic papule with exaggerated skin markings on the pulp space (shown in Fig. 1, Fig. 2).
case_images: Intra-operative excision markings (note blue staining from Patent V dye injection to localise sentinel node).
case_images: gr3.jpg
case_images: PMC11803895_01_gr3.jpg
case_images: f0015
case_images: Following this, the patient underwent a 1 cm wide local excision, involving an amputation through the head of the middle phalanx and sentinel lymph node biopsy of the left axilla under general anaesthetic (shown in Fig. 3 - blue staining from Patent Blue V injection to allow localisation of sentinel lymph node).
case_images: Intra-operative appearance of axillary lymphadenectomy.
case_images: gr4.jpg
case_images: PMC11803895_01_gr4.jpg
case_images: f0020
case_images: A block dissection of the left axillary lymph nodes was subsequently carried out under general anaesthetic (shown in Fig. 4).
case_images: Post-operative healed appearance 6 months after excision.
case_images: gr5.jpg
case_images: PMC11803895_01_gr5.jpg
case_images: f0025
case_images: At his most recent follow-up, there were no new lesions or concerning features observed under dermoscopy, and no lymphadenopathy was noted indicating no recurrence or metastasis 18 months post-operatively (shown in Fig. 5).