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| Fig. 48.4 Inflammatory breast carcinoma presenting as an erythematous plaque on the anterior chest wall and red dermal papules on the shoulder. |
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| Fig. 48.3 Metastatic adenocarcinoma of the gastrointestinal tract presenting as skin-colored dermal and subcutaneous nodules. |
Cutaneous metastases most commonly present as a cutaneous nodule or group of nodules that may be movable or fixed to underlying structures. Less commonly, they may present as indurated plaques. They may be skin-colored (Fig. 48-3), violaceous, erythematous, or, rarely, pigmented (malignant melanoma). The overlying epidermis is usually intact, but large metastatic lesions may be eroded or ulcerated. Clinically, they may mimic primary cutaneous lesions, including epidermoid cysts, lipomas, primary cutaneous malignancies, neurofibromas, scars, pyogenic granulomas, cellulitis, and even dermatitis. Metastatic breast carcinoma may uncommonly present with distinct patterns, including carcinoma erysipelatoides (inflammatory carcinoma; Fig. 48-4), carcinoma telangiectaticum (a variant of inflammatory carcinoma), and carcinoma en cuirasse (a sclerodermoid pattern).
