Survival outcomes of mucosal melanoma in the USA.

Background: Mucosal melanomas (MM) arise within the lining of the gastrointestinal (GI), genitourinary (GU) and head and neck (HN) systems. Method: A retrospective analysis of the National Comprehensive Database identified 4,961 MM patients. Primary objective was to compare survival outcomes across the different locations. Results: Overall survival for GI melanomas was significantly shorter than HN and GU melanomas. Median survival (95% confidence interval) was 19.5 (18.0-21.5), 26.4 (24.9-28.3), and 43.9 (38.8-47.8), months for GI, HN and GU cases, respectively (p<0.0001). Conclusion: This is the largest study of MM in a US based population, demonstrating worse overall survival for GI MM in comparison to HN and GU melanomas.

Amelanotic melanoma arising within a lesion of disseminated superficial actinic porokeratosis: An unusual presentation leading to a novel therapeutic approach.

Disseminated superficial actinic porokeratosis (DSAP) is the most common variant of porokeratosis with a potential for malignant transformation. Its association with malignant melanoma, however, is exceedingly rare. Treatment of DSAP is often ineffective. We report a unique case of amelanotic melanoma arising within a lesion of DSAP. The melanoma was managed surgically, and her DSAP were treated successfully with a novel approach utilizing 5-fluorouracil chemowraps.

Epidermotropic cutaneous metastases of squamous cell carcinoma from primary esophageal cancer: report of a case and review of the literature.

Metastatic squamous cell carcinoma (SCC) to the skin can be distinguished histologically from primary cutaneous squamous cell carcinoma as, unlike the latter, it is typically separated from the normal overlying squamous epithelium. Rare cases have been reported of cutaneous metastases of SCC that demonstrate continuity with the overlying benign squamous epithelium, termed "epidermotropic cutaneous metastases of SCC." We report the first case of epidermotropic cutaneous metastases of SCC originating from primary esophageal SCC with a review of the literature on this rare histological phenomenon.

Anaplastic large cell lymphoma localized to the left breast years after radiotherapy for breast cancer.

Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma that can involve the skin primarily or secondarily. Our case describes an unusual presentation of eruptive tumors localized to the leftbreast region several years following breast cancer surgery and radiation for carcinoma of the breast. This report highlights the challenges in reachingthe diagnosis of an aggressive systemic lymphoma presenting on the skin.

Benign and malignant hybrid adnexal tumors in a patient with epidermodysplasia verruciformis.

Epidermodysplasia verruciformis (EV) is a genodermatosis characterized by overgrowth of flat warts, pityriasis versicolor-like lesions and an increased propensity for developing cutaneous squamous cell carcinomas due to abnormal susceptibility to infection with beta-human papilloma viruses. Adnexal tumors are not typically associated with EV. Here we report a spectrum of hybrid adnexal tumors with divergent eccrine and folliculosebaceous differentiation, and cytologic features ranging from benign to frankly atypical, in a patient with inherited EV.

Histiocytoid autoimmunity-related neutrophilic dermatosis in a patient with rheumatoid arthritis.

Autoimmunity-associated neutrophilic dermatoses are a recently recognized manifestation of connective tissue diseases, in particular, lupus erythematosus. These entities are clinically and sometimes histopathologically distinct from classic neutrophilic dermatoses. We describe a case of an autoimmunity-related neutrophilic dermatosis in a patient with rheumatoid arthritis. In addition to this uncommon association, there was an absence of mature neutrophils and a population of immature histiocytoid granulocytes. This unusual case expands the concept of histiocytoid neutrophilic dermatoses to include those seen in association with autoimmune connective tissue diseases.

Hyperkeratotic and hypertrophic lichen nitidus.

Lichen nitidus typically presents as shiny pin-head sized papules on the trunk and extremities, often affecting children and young adults. In this prototypical form, it rarely presents a diagnostic challenge being characterized by distinctive clinical and histopathologic findings. We describe a rare variant of lichen nitidus, which we term "hyperkeratotic and hypertrophic lichen nitidus."

Porocarcinoma of the Left Foot: A Case Review.

Eccrine porocarcinoma is a rare malignant tumor of the eccrine sweat gland. This malignancy occurs most commonly in the lower extremities. It tends to occur in patients aged 60 to 80 years, affecting men and women equally. We present the case of a 62-year-old man with a lesion on the left foot. The diagnosis of the initial biopsy was squamous cell carcinoma. Six months later, the lesion reoccurred, and a second biopsy confirmed it to be eccrine porocarcinoma.

Treatment of unresectable cutaneous squamous cell carcinoma with pembrolizumab.

Currently, there are few effective therapies for locally advanced and metastatic cutaneous squamous cell carcinoma (cSCC); however, there is recent evidence supporting the use of immunological therapies in cSCC given the typically high mutation burden and association with immunosuppressed states. This report describes a 56-year-old man presenting with synchronous, invasive cSCC on the right temple and right dorsum of the hand deemed unfavourable for surgical resection. The patient was treated with nine infusions of programmed cell death protein 1 (PD-1) inhibitor therapy, pembrolizumab, with clinical and radiographical resolution of his lesions. This case illustrates the potential use of anti-PD-1 antibody as a first-line treatment in the setting of advanced, unresectable cSCC.