Keratinocyte carcinomas (KCs) are now an epidemic in The United States of America, especially in elderly patients. KCs, including basal cell carcinoma and squamous cell carcinoma, can lead to disfigurement and occasionally death. However, the lower mortality rate associated with KC compared with melanoma allows for increased flexibility in the selection of treatment. Flexibility in treatment is particularly important in the elderly given that this patient population often has medical comorbidities that should be considered. These patients may have multiple KCs, higher risk tolerance to recurrence, and different concerns about cosmetic outcomes compared with their younger counterparts. We review treatment options for KCs and how the selection of each option may affect the elderly patient.

Lichen planus–like atopic dermatitis clinically mimics lichen planus and can pose a diagnostic challenge. We report a case of a 55-year-old African American woman who developed intensely pruritic papules and plaques on bilateral hands. Histological examination demonstrated acute spongiotic dermatitis with lymphocyte exocytosis into the epidermis. Taken together, a diagnosis of lichen planus–like atopic dermatitis was made. This case serves to highlight that lichen planus–like atopic dermatitis can develop on hands and that it presents as spongiotic dermatitis with lymphocyte exocytosis into the epidermis. Correlating the clinical presentation with histopathological findings will assist in establishing the diagnosis and guiding appropriate management.

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Neutrophilic Eccrine Hidradenitis (NEH) is a rare inflammatory neutrophilic dermatosis that primarily affects eccrine sweat glands. Although it has been described in various malignancies and with therapeutic agents, it is most frequently associated with cytarabine-based induction chemotherapy for acute myelogenous leukemia. We report a rare case of NEH in a 63-year-old male with a medical history significant for primary CNS lymphoma. The patient was treated with high-dose thiotepa, busulfan, and cyclophosphamide (BuCy) followed by autologous stem cell transplantation, which was complicated by bacteremia and septic shock. Approximately three weeks after chemotherapy, he developed localized bright red, desquamating plaques on his bilateral outer hips, posterior upper thighs, and buttocks. Histological findings revealed neutrophils infiltrating and surrounding the eccrine glands accompanied by squamous syringometaplasia, apoptotic keratinocytes, and basovacuolar changes. This case serves to highlight that NEH should be considered in the differential diagnosis of erosive, erythematous plaques, especially in patients with lymphoproliferative tumors receiving high-dose chemotherapy, in order to provide appropriate clinical management.

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