Cutaneous Metastasis from Breast Carcinoma: a brief report of a rare variant and proposed morphological classification.

BACKGROUND: Breast carcinoma is the second commonest cancer in women after non-melanoma skin cancers and, excluding melanoma, the most common tumor to metastasize to the skin in women. Cutaneous metastasis from breast cancer has varied presentations but there is no well-established classification which includes them all. OBJECTIVE AND CONCLUSION: We report a 69 year-old lady with advanced primary ductal carcinoma of right breast (cT4cN1cM0) who presented five months after radical mastectomy with very extensive cutaneous metastases in absence of distant spread. Skin involvement was in the form of nodules and purpuric papulo-vesicles on a background of erythema which clinically mimicked lymphatic malformation. We also propose a morphological classification of the cutaneous metastasis from breast cancer. KEYWORDS: Breast Carcinoma, Cutaneous metastasis, lymphatic malformation.

Multiple eccrine hidrocystomas of the face.

BACKGROUND: Multiple eccrine hidrocystomas of the face are a rare facial dermatosis for which no recent large series of cases has been reported. OBJECTIVE: To describe the clinicopathologic features of five cases of multiple eccrine hidrocystoma and to emphasize their similar characteristics. METHODS: The clinical and histologic features of five women with multiple eccrine hidrocystomas of the face are described. RESULTS: All cases were middle-aged women with numerous, asymptomatic, skin-colored to bluish, papulonodular skin lesions, ranging from 2 to 5 mm in diameter, and mainly centrifacial in distribution. Histopathologically, all cases showed unilocular cysts in the dermis lined by two layers of cuboidal cells. Staining for S-100 protein was negative in the cyst wall in all cases. One case was treated with topical 1% atropine for 3 weeks with no significant improvement. No systemic side-effects were observed during this treatment. CONCLUSIONS: Multiple eccrine hidrocystomas are a rare condition which might be confused clinically and histopathologically with apocrine hidrocystomas. To date, no effective treatment has been reported.

Ectopic respiratory mucosa in the skin associated with skeletal malformation and polydactyly.

We report a 19-year-old man with congenital erythematous plaque on his left arm that was found histopathologically to be composed of respiratory mucosa. The patient had a triphalangeal thumb and polydactyly in the left hand. This is, to our knowledge, only the third case of ectopic respiratory epithelium presenting as a superficial lesion in the skin to be reported in the English literature, and the first case associated with skeletal malformation and polydactyly.

Reticulate acropigmentation of Dohi: a case report of autosomal recessive inheritance.

Reticulate acropigmentation of Dohi is a rare dyschromic disorder that generally has an autosomal dominant pattern of inheritance. Most of the cases have primarily been described from Japan. Only a few similar cases have been described elsewhere. We describe 3 black siblings, one boy and two girls, who had progressive reticulate hyperpigmented and hypopigmented macules over the dorsa of hands and feet, which began in early childhood. There were no palmar pits or breaks of the epidermal rete ridge pattern nor was there a family history of any pigmentary skin diseases. Three skin biopsies were performed on one patient; a biopsy specimen from a hyperpigmented macule showed increased melanin in all epidermal levels tapering towards the surface, a second biopsy specimen from a hypopigmented macule showed much less melanin, but it had a similar distribution. A third specimen from a hyperpigmented macule for electron microscopy showed a moderate number of stage III and IV melanosomes in the cytoplasm of the melanocytes. To our knowledge, these patients are the first cases reported from the Middle East with an autosomal recessive pattern of inheritance, confirming previous reports.

Scleromyxedema: possible association with seminoma.

Although scleromyxedema has been associated with neoplasm in rare instances, the literature showed no evidence of association with seminoma. We report a 43-year-old man who presented with a scleromyxedema and relapsed seminoma. The skin lesions of scleromyxedema cleared completely on treatment of seminoma with chemotherapy.