Nail bed malignancies are rare entities. Most nail bed malignancies are squamous cell carcinoma (SCC)s. Less than 10% of subungual SCCs occur in the foot. Fifty percent occurred on the hallux and approximately 25% on both the fourth and fifth digits. The correct diagnosis is often delayed because nail bed malignancies are frequently mistaken for benign or infectious processes. SCC on extremities is hard to distinguish from the benign lesion like chronic ulcer, fistula caused by chronic osteomyelitis, and abscess fistula. Attention should especially be paid in diagnosing the subungual lesion because paronychia is a common disease. SCC is the most common carcinoma second to malignant melanoma as a soft tissue malignant tumor in the West, and it involves mainly the head, neck and upper extremities but rarely involves lower extremities, particularly the toes. The authors emphasize the importance of a biopsy for chronic nonhealing lesions by presenting this case.