Subject No. 2. This 70-year-old Rongelap woman was 38 years of age at the time of exposure. She was felt to be one of two patients most heavily exposed to external beta radiation. She did not wash off the fallout debris for a full 24 hours. Within a few days skin lesions developed. The burns, most first degree, eventually included the neck, neckline, left hand and wrist, left cheek, Serum prolactin Two pituitary tumors have been identified in the exposed Marshallese (Adams et al. 1984). Because other exposed persons might develop these benign neoplastic lesions, prolactin levels are performed every two years. Although serum prolactin elevation is not found in all pituitary tumors, it is by far the most common hormonal abnormality and therefore is used as the screening test for the exposed population. No new or unexplained elevations were detected for the present reporting period, but one elderly Utirik woman still has the slightly elevated level mentioned in a previous Brookhaven report (Adamset al., 1985). A CT scan of the patient’s sella turcica in 1990 revealed no tumor. forehead, thorax and groin, lasting another few weeks. There was some hair loss. One year later the skin had essentially healed, except that there was persistent beta-burn scarring on the left side of the neck noted up to 1960. Followup skin examinations were benign until April 1986 when two skin lesions were noted: a 4 mm papule in the right supraorbital area and a7 mm nodule anterior to the right ear. Excisional biopsies revealed both to be basal cell carcinomas. Reexamination up to 1992 has revealed no evidence of recurrence. Skin cancer in dark-skinned races has generally been considered to be rare. Studies in a black population suggest that skin cancer occurs at the site of old burns or other scars, chronic ulceration Neoplasms: Skin cancers One basal cell carcinoma of the face was diagnosed in an exposed Rongelap woman in 1986 (Adamset al., 1988). A second person, also in the Rongelap exposed group, had a basalcell carcinoma removed in 1991. The development of two skin cancers some thirty years post-exposure in a population not considered susceptible to such lesions raises the possibility that there is some relation to their 1954 beta radiation exposure. The specific clinical situations are described below. Subject No. 1. This 56-year-old Rongelap man was 18 years of age at the time of his exposure to fallout from BRAVO. He washedoff the debris within several hours after the fallout ceased. He sustainedfirst-degree burns to his right antecubital fossa and both feet. These became apparent several weeks after exposure and lasted for several weeks. He also experienced typical nail discoloration. One year later on reexamination healing was complete. Subsequent skin examinations were unremarkable until April 1991 when a 1.5 cm lesion with a necrotic center was noted on his left scapula. An excisional biopsy was performed andthefinal pathological diagnosis was basal cell carcinoma. The tumor extended to all lines of excision. Therefore, definitive treatment consisted of a reexcision a few months later. Subsequent examinations have revealed no evidence of recurrence. and infection (Oettlé, A.G.; Databo-Brown, D.D.; and Fleming I.D. et al.). These cancers are usually squamous cell carcinomas and are invasive and aggressive (Amonette, R.A. and Kaplan, KJ., and Fleming I.D. et al.). Basal cell carcinomas, when they do occur, are located in sun-exposed areas, as they are in Caucasians. That there is a relative increase in incidence of skin cancerin black albinos or those of mixed race when compared to pure Blacks (Oettlé, A.G. and Burns, J.E.) suggests that melanin is a protective factor. Other ethnic groups have not been extensively studied. Ionizing radiation from sources other than sunlight is also known to be a risk factor in the induction of skin cancer (Davis, M.M., et al; Walther, R.R. et al.; and Myskowski, P.L. et al.). Studies of children irradiated for ringworm (Shore, R.E., et al.; and Ron, E., et al.) and other patients irradiated for a variety of conditions (Davis, M. et al.; Walther, R. et al.; and Myskowski, P. et al.) show that radiation is associated with an increased incidence of skin cancer, mostly basal cell tumors, and generally occurring among Caucasians, but occasionally in Blacks. The skin cancer in the Rongelap woman (#2) occurred in an area that was both sun-exposed and previously injured by beta radiation. For the Rongelap man (#1) neither sun nor beta radiation would have been expected to converge on the 13