Jordan Isenberg,¹ Tessa Weinberg,² Nowell Solish,^3
1McGill University, Faculty of Medicine, Montreal, Quebec; ²The Royal College of Surgeons in Ireland, Faculty of Medicine, Dublin, Ireland;
³University of Toronto, Department of Dermatology, Toronto, Ontario.

Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous malignancy. It is seen most frequently in those over 60 years old and in Caucasian males. It usually presents as an asymptomatic rapidly growing violatious nodule on a sun exposed area. The mainstay of treatment is surgical by standard wide local excision or MOHs chemosurgery. Radiation is added frequently for local control. The only factor significantly associated with overall survival is the stage of disease at presentation. This stresses the importance of early diagnosis and treatment.
Key Words: Merkel cell carcinoma, wide local excision, MOHs chemosurgery, adjuvant radiotherapy, review, case.

Francesca Cheung, MD CCFP, is a family physician with a special interest in dermatology. She received the Diploma in Practical Dermatology from the Department of Dermatology at Cardiff University in Wales, UK. She is practising at the Lynde Centre for Dermatology in Markham, Ontario and works closely with Dr. Charles Lynde, MD FRCPC, an experienced dermatologist. In addition to providing direct patient care, she acts as a sub-investigator in multiple clinical studies involving psoriasis, onychomycosis, and acne.

Abstract
Erythema ab igne (EAI) is a localized hypermelanosis with erythema in a reticulated pattern. It is triggered from repeated exposure to heat and infrared radiation. Actinic keratosis, squamous cell carcinoma, and Merkel cell carcinoma have been reported in patients after chronic exposure to infrared radiation. EAI is diagnosed based on clinical symptoms. If the diagnosis is uncertain, a skin biopsy may be performed. Early in the disease process, elimination of the heat source may lead to complete resolution of the symptoms.