Dermoscopy of Skin Metastases From Breast Cancer

Two Case Reports

Awatef Kelati; Salim Gallouj

Disclosures

J Med Case Reports. 2018;12(273) 

In This Article

Case Presentation

The authors report two Moroccan cases of dermoscopy in skin metastasis of breast cancer with two different clinical presentations; the dermoscopic examination was performed using a Dermatoscope Delta® 20 (Heine; Herrsching, Germany) with polarized light and without immersion.

Case 1 was a 51-year-old Moroccan woman diagnosed as having infiltrating ductal carcinoma of the left breast. Case 2 was a 65-year-old Moroccan woman diagnosed as having infiltrating ductal carcinoma of the right breast. They underwent mastectomy and axillary node dissection followed with adjuvant hormone and chemotherapy. After a remission period of 14 months (Case 1) and 10 months (Case 2), they were referred to our hospital for painful lesions on the surface of their trunk, chest, and back.

For Case 1, a physical examination revealed irregularly distributed pink nodules of various sizes with a large firm, indurated skin on and around the mastectomy scar of her left chest (Figure 1). For Case 2, a physical examination revealed a diffuse well-demarcated erythema and edematous cellulitis-like skin on the right side of her chest wall and her back, with a central ulceration on her abdominal wall (Figure 2) and palpable lymphadenopathy in her bilateral anterior cervical and supraclavicular chains. Dermoscopic examination of the two cases revealed a pink-orange background, yellow central areas, linear irregular and polymorphic vessels, whitish bright lines, whitish structureless areas, and linear irregular fissure-like depressions. A recurrence of ductal carcinoma was confirmed with skin biopsies, and the patients were referred to the oncology department for further investigations and appropriate management (Figs. 3 and 4).

Figure 1.

Case 1: Clinical presentation. Multiple irregularly distributed pink nodules around the indurated mastectomy scar on the left chest wall

Figure 2.

Case 2: Clinical presentation. Diffusely swollen, erythematous, indurated, and ulcerated skin with a cellulitis-like appearance of the right chest wall and the back

Figure 3.

Case 1: Dermoscopy of the skin metastases. Linear, irregular, arborizing and polymorphic vessels at the periphery of purples lesions (blue circle), structureless yellow areas (red star), bright white lines at the periphery of yellow areas (orange arrow), white structureless areas (violet star), linear skin depressions as fissure-like structures (green arrow)

Figure 4.

Case 2: Dermoscopic image of the skin metastases. Linear, irregular, arborizing and polymorphic vessels (blue circle), structureless yellow or yellow-orange areas (red star), white lines (orange arrow), white structureless areas or around yellow structures (violet star), linear skin depressions as fissure-like structures (green arrow), and pink structureless areas (blue arrow)

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