case_images: PMC5841099_01
case_images: Large ulcerative lesions of the right thorax, with subcutaneous fat layer exposed, upon presentation: anterior upper ((a), size 15 x 9 cm), anterior lower ((b), 6 x 7 cm), and lower neck seen both in anterior and posterior views ((c), 1 x 1 cm) and the back ((d), 15 x 12.5 cm). One additional lesion in the left back (3.5 x 2 cm) is not shown. There is evidence of invasion to the underlying muscle (a, d) and pronounced nodularity (a, c, d).
case_images: CRIDM2018-2354146.001.jpg
case_images: PMC5841099_01_CRIDM2018-2354146.001.jpg
case_images: fig1
case_images: He reported bleeding over several years from multiple skin lesions of the anterior (15 x 9 cm) and posterior (15 x 12.5 cm) right shoulder, right chest (6 x 7 cm), right neck (1 x 1 cm), and left back (3.5 x 2 cm) that correlated with significant occupational ultraviolet light exposure (see Figure 1).
case_images: PMC5841099_02
case_images: PMC5841099_03
case_images: Lesions of the right thorax before (left) and six months after (right) radiation showing excellent response to radiation (66-76 Gy) with concurrent and adjuvant vismodegib: (anterior upper (a); anterior lower (b); lower neck (c); and back (d)). All lesions completely resolved with complete skin closure, including an additional left back lesion (not shown).
case_images: CRIDM2018-2354146.002.jpg
case_images: PMC5841099_03_CRIDM2018-2354146.002.jpg
case_images: fig2
case_images: By 6 months following radiation treatment, all lesions showed complete response with near-complete skin closure (Figure 2).