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The aim of this work is to identify any potentially druggable genomic alterations for possible targeted therapies. Cases of primary or recurrent\/metastatic (RM) SAC between 2002 and 2014 were identified by searching the institutional cancer registration database. Histological sections of all referral cases were reviewed by a dedicated pathologist to confirm diagnosis. Immunohistochemistry was performed to assess the expression of androgen receptors (AR) and human epidermal growth factor receptor type 2 (HER2). Targeted next\u2010generation sequencing (T\u2010NGS) was performed to identify targetable mutations (panel of 50 genes analyzed by Cancer Hotspot Panel, Ion\u2010Torrent Personal Genome Machine). Mutational analysis of the <jats:italic>PTCH1<\/jats:italic> gene not present in the T\u2010NGS panel was assessed by Sanger sequencing. A total of 45 cases with available histological samples were identified (35 primary, 10 RM). The most frequent histological type was porocarcinoma (<jats:italic>n<\/jats:italic>\u00a0=\u00a012). Globally, 14 cases (31%) were AR+ (6\/10 RM, 60%; 8\/35 primary, 23%). HER2 was shown as 2+ in eight of 42 (19%) cases (2\/9 RM, 22%; 6\/33 primary, 18%). DNA was adequate for T\u2010NGS analysis in 25 cases. In the majority of cases (17 cases, 68%) at least one mutation in oncogenes or tumor suppressor genes was found: the most frequent ones involved TP.53 (13 cases, 76% of mutated SAC) and <jats:italic>PIK3CA<\/jats:italic> (three cases, 18%). The rate of <jats:italic>PTCH1<\/jats:italic> mutation was 30%. These findings support the use of molecular screening in patients with advanced SAC.<\/jats:p>","DOI":"10.1111\/1346-8138.14889","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T02:37:36Z","timestamp":1556678256000},"page":"507-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Identification of potentially druggable molecular alterations in skin adnexal malignancies"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1294-6859","authenticated-orcid":false,"given":"Stefano","family":"Cavalieri","sequence":"first","affiliation":[{"name":"Head and Neck Medical Oncology Unit Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Busico","sequence":"additional","affiliation":[{"name":"Department of Pathology Fondazione IRCCS Istituto Nazionale dei 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