A 55-year-old man was diagnosed as having mycosis fungoides classified as stage IIB (T3, N0, M0)and had been receiving ultraviolet therapy and electron beam irradiation. Although he achieved remission using this treatment regimen, his skin lesions recurred, and systemic administration of etoposide was initiated. Following a partial response, his skin symptoms gradually worsened, and he presented with multiple deep ulcerations on his skin, including the development of lesions on his right arm. Alternatively, oral bexarotene monotherapy (300 mg/m²/day) was introduced, and he showed an improvement in the ulcerations. Oral bexarotene monotherapy could be an effective treatment option for patients diagnosed with mycosis fungoides, presenting with skin ulcerations refractory to treatment using systemic etoposide.[Skin Cancer (Japan) 2017 ; 32 : 192-196]

Combination therapy using cetuximab and radiotherapy is a promising treatment option for the management of locally advanced head and neck squamous cell carcinoma (SCC). Moreover, some reports have shown that the treatment of unresectable cutaneous SCC in combination with radiotherapy is also effective. We report three cases of cutaneous SCC treated with cetuximab and radiotherapy. Patients were initially administered cetuximab at a loading dose of 400 mg/m², followed by administration of weekly infusions of 250 mg/m² during radiotherapy. One patient achieved complete response and two patients did partial response. No patient demonstrated adverse effects over Grade 3. We suggest that combination therapy using cetuximab and radiotherapy is potentially useful for the management of unresectable cutaneous SCC.[Skin Cancer (Japan) 2017 ; 32 : 197-201]

A 43-year-old man complained of a subcutaneous mass in the occipital region. The previous doctor attempted puncture and removal, but only partial resection was performed due to bleeding.

Pathologic examination of resected specimens by the previous doctor raised suspicions of malignant melanoma.

Craniectomy was performed with a 1.5-cm margin around the back of the black spot. Additional resected skin and sentinel lymph nodes were negative, but the tumor cells grew invasively via blastocyst formation on the skull suture line, and the deep margin was positive. Since dural infiltration was also suspected, the surface of the skull, dura, and cerebral cortex were also subsequently excised ; however, these were negative.

Although burn scar carcinoma with dural infiltration from the skull suture line has been previously reported, to date there are no reports of malignant melanoma infiltration into the cranium through the skull suture line.[Skin Cancer (Japan) 2017 ; 32 : 202-206]

A 32-year-old woman presented with a nodule in her right vulva that had enlarged during pregnancy for two years. The tumor was 3 × 2 cm in size, pinkish, and soft. Dermoscopy revealed a pinkish background with arborizing vessels, multiple blue-gray globules, and a partial blue-white area. Histological examination indicated that the tumor consisted mostly of a large cyst. The lumen of the cyst was surrounded by follicular germinative-like cells. Necrotic tumor cells and mucin were reported. There were compact solid nests with palisade, clefts, and mutin that were positive for colloidal iron and alcian blue. The diagnosis of cystic basal cell carcinoma was confirmed based on the tumor cells' positive staining for BerEP4 and Bcl-2, and negative staining for CK20. Enlarging tumors that develop during pregnancy are mostly mesenchymal, and are rarely epithelial tumors such as basal cell carcinoma. It is unknown why the tumor cells enlarged during pregnancy, since they lacked hormone receptors.[Skin Cancer (Japan) 2017 ; 32 : 207-210]

A 75-year-old woman was referred to our hospital for the treatment of the mass in the occipital region which had been noticed nearly 10 years ago. Microscopic examination revealed the tumor invasion throughout the dermis and subcutaneous tissue with fibrosis. In the upper dermis, small cysts with horny substance were observed, and tumor strands with eccrine sweat gland differentiation and small nests were detected in the lower dermis. It was diagnosed with Microcystic Adnexal Carcinoma (MAC). The tumor was excised with 20 mm tumor-free-margin including a part of trapezius muscle and skull periosteum. After confirming the negative margin, the defect was covered with a free anterolateral thigh flap. At 6 months after the operation, no recurrence has occurred.[Skin Cancer (Japan) 2017 ; 32 : 211-215]