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Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. BCCs are categorized into “easy-to-treat” and “difficult-to-treat” groups, with the latter including all BCCs that are challenging to manage due to technical, patient-related, or tumor-related factors, such as locally advanced BCCs. In this report, we describe an 84-year-old patient with an extensive, unilateral BCC. Following a decision by the multidisciplinary skin cancer board, the patient was successfully treated with a daily dose of 200 mg of sonidegib, an inhibitor of the Hedgehog pathway, for eight months, acquiring complete clinical and histopathological remission. No significant side effects were reported. The follow-up period of 24 months has shown no negative results.

Pityriasis versicolor is characterized clinically by slightly scaly, hyper- or hypopigmented macules usually located on the chest, shoulders, back and arms. Rare cases of atypical locations of pityriasis versicolor have been described, such as groins, penis and perineum. We present three cases of pityriasis versicolor located exclusively on the submammary folds, pubis and inguinal folds (the latter in an 11-year-old girl), respectively. In consideration of both location and clinical presentation of pityriasis versicolor in these three patients, we think that the diagnosis of “erythrasmoid” pityriasis versicolor is acceptable. Differential diagnosis with erythrasma must be taken into consideration. Mycological and bacteriological examinations are therefore necessary in order to make a correct diagnosis and specific therapy.

Introduction. The constant increase in the incidence of non-melanoma skin cancers (NMSC) makes their treatment a topic of paramount interest. Because most of NMSC tend to develop in visible areas such as head-neck area, it is a priority to choose the less destructive therapy and more appropriate reconstructive technique. Mohs Micrographic Surgery (MMS) represents the treatment of choice for skin tumors in critical sites, recurrent tumors and tumors with aggressive histologic features. Patients and Methods: We collected patients affected by NMSC who underwent MMS at the Dermatology Unit of IRCCS Fondazione Ca' Granda, Milan, in the period March 2017 - December 2021.Results. 159 patients were enrolled in this retrospective observational study. The excision margins were chosen based on a dermoscopic evaluation. The main histological diagnoses were basal cell carcinoma (145, 91.2%) and squamous cell carcinoma (10, 6.3%), in areas with high functional or anatomical value. 121 out of 159 surgeries did not require further enlargement after the removal of the clinically and dermoscopically visible lesion, but in 38 cases (23.9% of cases) the Pathologist required at least one subsequent enlargement, due to the persistence of neoplasm at the bottom or at the margins of the lesion. Only one recurrence has been reported so far. Conclusions: MMS is a pathology-controlled surgery with high intrinsic value because of the low risk of recurrences and should be routinely adopted for high-risk NMSC.