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Summary: Background: Recent studies have shown an increasing incidence of cutaneous adnexal carcinomas (CACs). Objectives: The aim of our study was to evaluate incidence and survival for cases of CACs and investigate their association with other skin neoplasms. Methods: We conducted a population‐based study. Data on incident cases of CACs were obtained from the Tuscany Cancer Registry between 1985 and 2010. In order to determine whether the occurrence of squamous cell carcinoma (SCC) among patients with CAC is higher or lower than expected in the general population, the standardized incidence ratio (SIR) was calculated. Results: A total of 242 patients with CAC were observed; the age‐standardized incidence rate was 3·8 cases per million person‐years. From 1997 to 2010 crude incidence rates increased by 159%. Age‐specific incidence was higher in men over 80 years old than in women of the same age and younger individuals. Carcinomas of sweat gland origin prevailed; the most common histotype was porocarcinoma and the most frequently affected site was the head/neck. Overall, 88% of CACs were diagnosed at a localized stage. The 5‐year overall survival and disease‐specific survival rates were 59% [95% confidence interval (CI) 53–65] and 94% (95% CI 91–98), respectively. In the observation cohort, the number of SCCs was significantly higher than expected as the SIR was calculated to be 33·7 (P < 0·001). Conclusions: Increasing incidence warrants awareness and early diagnosis of CACs. Increased SCC incidence among patients with these tumours highlights the relevance of careful skin examination and follow‐up. What's already known about this topic? Cutaneous adnexal carcinomas (CACs) are rare tumours, but their incidence is increasing.The rarity of these tumours has made it difficult to gain sufficient clinicopathological experience regarding the diagnosis and treatment of CACs.CACs can be a diagnostic challenge owing to mostly nonspecific clinical presentation and histopathological variety that often requires specific expertise for a definite diagnosis. What does this study add? CAC incidence increased from 2·5 per million person‐years in 1985–87 to 19 per million person‐years in 2009–10; from 1997 the incidence has constantly increased, rising to 159% in 2010.In patients with CAC, the risk of squamous cell carcinoma is 34 times higher than in the general population.Considering demographic evolution with a progressively ageing population and higher incidence of CACs among the elderly, it is reasonable to expect a further increase in the future. Respond to this article Linked Comment:Andersen. Br J Dermatol 2019; 180:453–454. Plain language summary available online [ABSTRACT FROM AUTHOR]

Metastasis is a common cause of morbidity and mortality in patients with cancer. Tissue trauma and any ensuing chronic inflammation could facilitate metastasis through two distinct but not mutually exclusive pathways. [Extracted from the article]

Linked Article: De Giorgi et al. Br J Dermatol 2019; 180:565–573 [ABSTRACT FROM AUTHOR]

Summary: Globally, skin cancer is one of most common forms of cancer. There are several types, the most common being non‐melanoma skin cancer, which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). In the UK, more than 100,000 new cases of non‐melanoma skin cancers are diagnosed every year. Cutaneous adnexal carcinomas (CACs) are rare tumors which are often difficult to diagnose. This study, from Italy, aimed to evaluate how the number of CACs in the population has changed over time and identify if there is a link between CAC presence and the risk of developing SCC. Data was analysed from the Tuscany Cancer Registry (TCR) from a 25‐year time period between 1985 and 2010. 242 patients with CACs were identified from this period with the number of patients with CACs growing from 2.5 per million in 1985‐87 to 19 per million in 2009‐10. Between 1997 and 2010, CAC presence in the population increased by 159%. It was also found that patients with CAC were 34 times more likely to develop SCC later in life than those without CAC, suggesting that this is a significant risk factor. The authors of this study predict that the number of patients with CAC is likely to continue to increase, due to an ageing population. This combined with the link between CAC and SCC highlights the need to improve diagnosis of CACs in the future. Linked Article: De Giorgi et al. Br J Dermatol 2019; 180:565–573 [ABSTRACT FROM AUTHOR]