Skin as a Mirror to Internal Malignancy: A Rare Co-presentation of Nail Bed Squamous Cell Carcinoma and Renal Cell Carcinoma

Squamous cell carcinoma (SCC) of the nail bed is not encountered commonly although it is the most common primary malignancy at this site. In general, it has a low rate of spread, except for high risk types which carry a greater risk of spread. Screening for systemic tumours should be done in all cases especially in the elderly. We present the case of a 67 year old male who was otherwise healthy and presented with just nail discoloration associated with pain and occasional profuse bleeding with minor trauma which turned out to be SCC of nail bed on biopsy. Subsequently, he was screened for internal malignancies and was found to have clear cell Renal cell carcinoma of right kidney and a metastatic nodule in right lung. This presentation has not been previously described in literature.