How would you manage eccrine porocarcinoma of the great toe with positive superficial groin and pelvic lymph nodes s/p toe amputation and pelvic lymph node dissection?

Eccrine porocarcinoma (EPC) is an aggressive but rare skin malignancy, let alone one occurring at the great toe! A meta-analysis (Salih et al., PMID 28721214) of worldwide reports on EPC prior to 2016 offered a good overview of the disease’s natural history. It was noted that 31% had metastasis upon...