Head and neck adnexal skin cancers

Purpose of review: Adnexal carcinomas (AC) are rare skin lesions predominantly affecting elderly individuals. These tumors are often located in the head and neck region and are influenced by factors such as sun exposure, prior radiation therapy, and immunosuppression. Understanding the pathogenesis and management of AC is crucial for improving patient outcomes. Recent findings: AC may arise de novo or from preexisting benign lesions. They may act as cutaneous markers for hereditary syndromes, highlighting the need for their early identification. Accurate diagnosis is critical, requiring adequate biopsy for proper characterization, as superficial excisions may lead to mistakes. Surgical treatment remains the primary approach, with wide (at least 1 cm) surgical margins also recommended for lesions with lower malignancy potential. Mohs surgery is particularly useful for tumors located in cosmetically sensitive areas, offering precise resection and clear margins. Summary: AC are classified into good, intermediate or poor prognosis categories based on the risk of local recurrence and distant metastasis. This classification assists in determining the need for adjuvant treatments and follow-up strategies. The proper understanding of risk factors, pathogenesis, and treatment options is essential to improve outcomes and ensure optimal management of AC.