GNRH1 and skin reaction: Four (31%) patients underwent neoadjuvant treatment with gonadotropin releasing hormones (Gn-RH) (one case) [12], chemotherapy (paclitaxel + cisplatin, one cycle) (one case) [10], chemotherapy (5-fluorouracil with leucovorin and oxaliplatin, mFOLFOX6) + panitumumab (seven courses) (one case, initially misdiagnosed as an anal fistula adenocarcinoma, achieving partial response) [6] or radiotherapy (RT) (19 fractions, then discontinued for severe skin reaction; partial response) [15].