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Neoplastic lesions (benign or malignant) in the nail region are rare when compared to lesions in the rest of the skin. Despite advances in diagnostic modalities, their diagnosis is frequently delayed or overlooked for days, months, or even years when they are misrecognized or when their approach is not appropriate. Undoubtedly, malignant tumors are the most important lesions since an inopportune diagnosis or treatment can drastically change the patient's prognosis. A review of all the scientific evidence on the two main malignant neoplasms of the nail apparatus (melanoma and squamous cell carcinoma) was carried out using the PubMed search engine from 2003 to 2022, in order to expose the appropriate diagnostic approach and treatment of these nail lesions to avoid delays that obscure the prognosis of patients. This review does not include reconstruction modalities after lesion resection, but the emphasis is placed on the great functional impact they produce. Surgical treatment in the early stages is the most important when talking about prognosis and emphasizing it; systemic oncological management of advanced stages is not so deep., Competing Interests: National Council for Science and Technology (CONACYT). Mex.: Two of the authors are recipients of the National Quality Postgraduate Plan (PNPC in Spanish) scholarship, (Copyright © 2022, Acuña Pinzon et al.)

Giant condyloma acuminatum (GCA) or Buschke-Loewenstein tumor is a rare disease, with an estimated prevalence of 0.1%. It was initially described in 1896 by Buschke and later in 1925 by Buschke and Loewenstein. Classic condyloma acuminata (CCA) and squamous cell carcinoma (SCC) were initially described as different entities. These three entities are currently considered to correspond to the same spectrum of different but not exclusive malignant transformations, associated with multiple risk factors such infection by human papilloma virus (HPV), immunodeficiencies, poor hygiene, multiple sexual partners, and chronic genital infections. HPV subtypes 6 and 11 are associated with 90% of GCA. It presents as a cauliflower-like tumor in the genital region with bad odor, bleeding, and local infection, differential diagnosis with multiple conditions should be considered, and sexually transmitted diseases should always be investigated. GCA has a higher rate of malignant transformation than CCA and tends to infiltrate adjacent soft tissues. The therapeutic approach is controversial but is considered that the resection with free edges is the gold standard and can be combined with adjuncts. The recurrence rate is high. Overall mortality is 21% and is associated with morbidity caused by recurrences. Imiquimod cream 5% has recently shown good results as monotherapy and in combination with ablative and surgical treatments. The quality of life is diminished in patients with this condition. In this review, we address the different aspects of this rare entity including the therapeutic approach., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Jefferson F. Nieves-Condoy et al.)