JAMA Oncol. 2017 Aug 17. [Epub ahead of print]
An Erysipeloid Cutaneous Eruption in a Woman With Advanced Breast Cancer.
Alexander CE, Maarouf M, Kurtzman DJB.
University of Arizona, Tucson.
A woman in her 60s with a history of metastatic breast cancer presented with a 3-month history of a progressive, asymptomatic cutaneous eruption of nontender discrete erysipeloid plaques on her chest and back. What is your diagnosis?
A woman in her 60s presented with a 3-month history of a progressive, asymptomatic cutaneous eruption on her chest and back. She had a complex history of breast cancer on the left side that was first diagnosed in 1991 and was treated with lumpectomy, radiotherapy, cyclophosphamide, methotrexate, and fluorouracil. In 2001, she experienced local disease recurrence and underwent complete mastectomy with axillary lymph node dissection on the left side and received adjuvant treatment with tamoxifen citrate and anastrozole. In 2014, she developed axillary lymphadenopathy on the right side and was found to have metastatic disease. She subsequently underwent axillary lymph node dissection on the right side, followed by treatment with doxorubicin hydrochloride and cyclophosphamide. Her most recent mammogram and positron-emission tomography–computed tomography (PET/CT) showed no evidence of active disease. At the time of her evaluation, the patients physical examination was remarkable for discrete erysipeloid plaques on her chest, back, and right shoulder (Figure 1A). The lesions were warm and indurated but nontender to palpation. Serum chemistry profile, complete blood cell counts, and hepatic and renal function testing had normal results. Lesional skin biopsies were performed (Figure 1B).
Figure 1. A, Clinical examination shows discrete erysipeloid plaques on the anterior chest. B, Histopathologic analysis (hematoxylin-eosin stain, original magnification ×100).
What Is Your Diagnosis?
Carcinoma erysipeloides (cutaneous metastases of breast cancer)