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Current Treatment Options for Cutaneous Adnexal Malignancies
1Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, 36-1, Nishicho, Yonago, Tottori, 683-8503, Japan. higoto@tottori-u.ac.jp.
Opinion Statement:
Cutaneous adnexal malignancies include various types of malignant tumors that show differentiation of cutaneous appendages. They can be classified into sweat gland, hair follicle, and sebaceous gland differentiations. All types of cutaneous adnexal tumors are rare and standard treatment options based on valid evidence have not been established. Although prognosis differs depending on the type of cutaneous adnexal malignancy, surgery is the mainstay of treatment. In surgical treatment, an adequate surgical margin is unclear for wide local excision. Mohs micrographic is a better option than wide local excision in terms of margin control and cosmetic outcome because the face, head, and neck are favorable sites for some cutaneous adnexal malignancies. There has been no randomized trial of radiation therapy and chemotherapy for any cutaneous adnexal malignancies. Radiation therapy should be considered if the tumor cannot be removed surgically. Chemotherapy is one of the options for metastatic cases in some types of cutaneous adnexal malignancies, but evidence of the effectiveness of chemotherapy is lacking. Recent studies have revealed genetic mutations in this field, and target therapy and immunotherapy may be promising treatment options for unresectable cutaneous adnexal malignancies in the future.
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