Background: Agent Orange, an herbicide sprayed during the Vietnam War, is a known carcinogen. However, there have been no studies on its association with basal cell carcinoma (BCC) or the nature of BCC in defoliant-exposed patients. Objective: To determine the clinical and histological characteristics of BCC in patients exposed to defoliants. Methods: Chart analysis was performed on patients diagnosed with BCC at Veterans Health Service Medical Center from January 2011 to December 2020. The clinical data were compared between the defoliant-exposed and non-exposed groups. Histopathological characteristics were compared according to histological subtype and presence of pigmentation. Results: Of 227 patients with BCC, 117 were defoliant-exposed and 110 were unexposed. The mean age at diagnosis of skin cancer was 73.9 years. The age at diagnosis was significantly lower in the defoliant-exposed group than in the unexposed group (71.3 years vs. 76.7 years, p＜0.001). In most cases, BCC was identified as pigmented papules and nodules on the face. Nonpigmented lesions were observed more frequently in the defoliant-exposed group than in the unexposed group; however, this difference was not statistically significant. Histologically, the nodular type was the most common subtype in both groups. Additionally, 33.3% of the defoliant group and 25.9% of the control group showed melanin pigmentation, and no statistically significant difference was observed in tumor depth between the two groups. Conclusion As veterans of the Vietnam War advance in age, dermatologists should continuously pay attention to BCC in defoliant-exposed patients, and early diagnosis and proper management should be ensured.

Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by multiple nodules and papules, which are accompanied by intense pruritus. Treatment is challenging and requires a diverse approach. Recently, a few reports have described successful treatment of PN with dupilumab. We report a case of a patient with treatment-resistant PN who was successfully treated with dupilumab. Dupilumab was administered at the standard dose: an initial induction dose of 600 mg, followed by 300 mg every 14 days. Pruritus reduced after 2 weeks and almost completely disappeared after 4 weeks of treatment.