{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:20:25Z","timestamp":1747182025327,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 65\u2010year\u2010old Japanese man presented with a dome\u2010shaped nodule, the base of which was contiguous with a dull brown plaque, on the left leg. After local excision of the cutaneous lesion and left inguinal lymph node dissection, several dermal and subcutaneous nodules developed successively on the left lower extremity. Hematoxylin\u2013eosin staining of the primary cutaneous lesion demonstrated uniform neoplastic cells arranged in a trabecular pattern extending from the dermis to subcutis. Mitotic figures were abundant. Although the overlying epidermis was substantially intact, the Merkel cells had invaded the epidermis, resulting in Pautrier\u2010like microabscesses. The hyperplastic epidermis adjacent to the nodule consisted of abnormally growing atypical keratinocytes. The enlarged left inguinal lymph node and successive secondary nodules contained Merkel cells similar to those in the primary nodule. Immunohistochemically, most tumor cells were positive for <jats:styled-content style=\"fixed-case\">CAM<\/jats:styled-content>5.2, synaptophysin, chromogranin A, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>56 and vimentin. The tumor cells in the left inguinal lymph node were positive for <jats:styled-content style=\"fixed-case\">CAM<\/jats:styled-content>5.2, synaptophysin and cytokeratin 20 but negative for <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>2B4, and less than 1% of the cells expressed programmed cell death ligand 1. The patient was treated with avelumab, which showed significant efficacy against the in\u2010transit recurrence. Two months later, all nodules had disappeared completely. We describe a case of in\u2010transit recurrence of Merkel cell carcinoma that was associated histologically with Bowen's disease and was successfully treated with avelumab. Although accumulation of additional cases is needed, avelumab therapy may be a useful treatment for in\u2010transit recurrence of Merkel cell carcinoma.<\/jats:p>","DOI":"10.1111\/1346-8138.14829","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T08:27:03Z","timestamp":1551256023000},"page":"440-443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["In\u2010transit recurrence of Merkel cell carcinoma associated with Bowen's disease: The first reported case successfully treated by avelumab"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8608-9071","authenticated-orcid":false,"given":"Takahiro","family":"Kiyohara","sequence":"first","affiliation":[{"name":"Department of Dermatology Kansai Medical University Medical Center Osaka 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