Akademik Veri Yönetim Sistemi
8th International Dermatology & Cosmetology Congress- INDERCOS, İstanbul, Türkiye, 9 - 12 Mart 2023, ss.123
Cutaneous metastases are observed in 5.3% of
cancers and usually occur within 3 years of diagnosis.
Cutaneous metastases from breast cancer tend to be
located in the thoracic region. The dermatological
pattern of cutaneous metastases of breast cancer is
papulonodular lesions, but erysipeloid infiltration
is also possible. Carcinoma erysipeloides is a rare
condition observed in 3% of all cutaneous metastases.
It presents as a fixed, well-circumscribed erythematous
patch or plaque resembling cellulitis or erysipelas.
Differential diagnoses include cellulitis, eczema,
inflammatory breast cancer, radiation dermatitis, and
breast Paget’s disease. Here we will present a case of
carcinoma erysipeloides, which appeared as the first
sign of metastasis in a patient diagnosed with breast
cancer that was in remission.A 49-year-old female
patient was admitted to our clinic with an erythematous
patch observed on the anterior trunk for 1 month.
Systemic and local symptoms were absent. During
dermatological examination of the patient, there was a
25 cm surgical scar on the anterior side of the trunk and
a widespread erythematous patch around the scar that
faded with pressure. After diagnosis of breast cancer,
she underwent left total mastectomy in 2012 and right
total mastectomy in 2020. She had been treated by
letrazole for 18 months. No recurrence or metastasis
was observed 3 months ago. Considering the cellulite/
erysipel diagnoses in another center, she was started
on amoxicillin/clavulanic acid, topical isoconazole and
fusidic acid+betamethasone valerate cream treatments.
Despite this treatment for a week no improvement
was detected. According to current clinical data, 5 mm
punch biopsy was performed considering Carcinoma
Erysipeloides. In histopathological examination and
immunohistochemical studies, Proliferative activity
was observed with Ki-67 at a rate of 10-15% in invasive tumor cells. Since the patient had a clinical history of
breast carcinoma, breast carcinoma metastasis was
considered first.In this case, too, the patient developed
a well-defined cutaneous lesion resembling an acute
infectious process such as erysipel and/or cellulitis.
It was misdiagnosed as cellulite and given the wrong
treatment. The diagnosis of carcinoma erysipeloides
requires rapid diagnosis and treatment in order to
increase patient survival. Response to induction
chemotherapy is the most important prognostic factor.
The prognosis varies according to the underlying cancer
type, but generally low survival is observed.While
patients with breast cancer have a better prognosis than
other cancers, the estimated survival after diagnosis of
cutaneous metastases is 50% at 6 months.The median
survival for all forms of cutaneous metastasis in breast
cancer is 13.8 months, with a 10-year survival rate of
3.1%. This case report highlights the need for accurate
differential diagnosis of carcinoma erysipeloides and
prompt initiation of treatment.