Case 1: A 65-year-old woman presented with a moist red plaque on the perianal skin, which was confirmed to be squamous cell carcinoma. She had a history of resection for anal squamous cell carcinoma four years previously. Case 2: A 72-year-old woman presented with a perianal skin mass that had been growing slowly for two years. The lesion was suspected to be Bowen's disease, due to the pathological findings of squamous cell carcinoma in situ. Both patients were diagnosed with anal squamous cell carcinoma rather than cutaneous tumors and were treated with chemoradiotherapy, resulting in complete clinical remission. Dermatologists should be aware that anal squamous cell carcinoma may resemble cutaneous squamous cell carcinoma or Bowen's disease and that these conditions must be strictly distinguished, because their standard management differs significantly.

In this study, we examined the clinicopathological characteristics of 7 cases of generalized morphea in patients with systemic sclerosis. All of the patients were female, and their mean age was 55.4 years. Clinical features included ill-defined or well-circumscribed pale pink or brownish erythema on the chest, abdomen, and back. Six patients complained of tingling or stabbing pain. GM lesions were distributed on areas susceptible to chronic friction or compression due to undergarments such as waistbands or brassieres. Histopathology of the generalized morphea revealed thickened collagen bundles in the mid-dermis, lower dermis, and whole dermis. Among the 7 cases, limited cutaneous systemic sclerosis was observed in 5, and diffuse cutaneous systemic sclerosis was observed in 2. The frequency of generalized morphea among systemic sclerosis cases diagnosed within the same period was 1.5%.

Clarifying the relationship between skin aging and systemic frailty could allow for the prediction of frailty risk through the assessment of skin symptoms. We organized a research group to investigate the connections between skin symptoms and systemic frailty, which we termed "skin frailty," and conducted a cross-sectional study using a color atlas to aid the assessment. A survey of 701 men and women aged 65 years or older, focusing on five skin symptoms (skin dryness, itching (scratch marks), senile purpura, toenail lesions, and skin atrophy), revealed that senile purpura and skin atrophy are associated with systemic frailty. The total score of the five items is also correlated with systemic frailty. In the future, we aim to establish the concept of skin frailty as a risk factor for systemic frailty through longitudinal studies.