Reactive infectious mucocutaneous eruption (RIME) is a mucosal‐predominant eruption that usually affects two or more mucosal sites. We present a case of RIME secondary to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and provide a brief review of the literature with a focus on the natural history and response to treatment. This entity may require inpatient management and systemic corticosteroids for symptom control in the pediatric population.

Merkel cell carcinoma (MCC) is a rare, aggressive primary neuroendocrine carcinoma of the skin that can present in immunocompromised patients. Kaposi sarcoma (KS) is an indolent angioproliferative tumor associated with human herpesvirus 8 (HHV8). The concurrence of both MCC and KS is rare, and there have been limited cases reported in the literature. We present a rare case of concurrent MCC and KS in an immunocompromised patient. To our knowledge, this is the first report of MCC and KS described in the same histopathological specimen. A 37-year-old Black male with a history of recurrent AIDS-related KS involving bilateral lower extremities was evaluated for a tender nodule on the left posterior leg. A punch biopsy was consistent with MCC. Magnetic resonance imaging brain and full-body positron emission tomography/computed tomography (PET/CT) scan were without evidence of distant metastasis. The patient underwent wide local excision with negative margins and completed postoperative radiation therapy. However, he later developed cutaneous metastasis of MCC to the left medial thigh and excision revealed residual MCC with adjacent KS. Treatment is still ongoing with pembrolizumab for both KS and MCC.

No abstract

Solid organ transplant recipients (SOTRs) are at an increased risk for developing skin cancers compared with the general population. 1 The increased risk of skin cancer among SOTRs is 65-fold greater for cutaneous squamous cell carcinoma (cSCC), 10-fold greater for basal cell carcinoma (BCC), and 3-fold greater for malignant melanoma (MM). 1 The risk of posttransplant skin cancer increases gradually over time after transplantation; however, a subset of SOTRs may present with earlier-onset skin cancer based on various risk factors, requiring timely evaluation and treatment by a dermatologist. With more than 400 000 living transplant recipients and more than 30 000 transplant procedures performed annually in the US, it is not feasible for all SOTRs to receive annual skin cancer screening. 2 Riskbased screening considers the feasibility of access to dermatologic care in a resource-limited setting and helps define which patients need more urgent referral to dermatology. 3 The Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) is a prediction tool created in 2019 to risk stratify SOTRs based on the likelihood of developing the first skin cancer posttransplantation, specifically cSCC, MM, and Merkel cell carcinoma (MCC). 4,5 This calculator was designed following recommendations of a Delphi panel of dermatologists and transplant physicians, which determined that skin cancer screening is warranted if the incidence of skin cancer in a specific population is at least 2%. 3,4 The goal of the SUNTRAC tool was to create a simple and effective screening tool for transplant physicians to prioritize posttransplant referrals for skin cancer screening. 4 The data for this tool were obtained from the Transplant Skin Cancer Network (TSCN) study, 5 a multicenter retrospective populationbased study across 26 transplant centers in the United States. This study identified risk factors and assigned a point value for each, including White race (9 points), pretransplant history of skin cancer (6 points), age ≥50 years at time of transplant (4 points), male sex (2 points), and thoracic organ transplantation (1 point). The calculator combines the points associated with each risk factor to create an additive scoring system that classifies patients into 4 risk groups of low, medium, high, and very high risk for skin cancer screening to be completed within 10 years, 2 years, 1 year, and 6 months, respectively. 4 The study in this issue of JAMA Dermatology by Gómez-Tomás et al 6 presents an external validation study of the SUNTRAC screening tool. This study included a prospec-

No abstract