A Rare Case of Zosteriform Cutaneous Metastases from a Nasopharyngeal Carcinoma

Abstract

From a clinical point of view, the most common presentations of cutaneous metastatic disease are papules and nodules. However, a wide morphological spectrum of lesions has been described, including erythematous patches or plaques, inflammatory erysipelas-like lesions, diffuse sclerodermiform lesions with induration of the skin, telangiectatic papulovesicles, purpuric plaques mimicking vasculitis, and alopecia areata like scalp lesions. The so-called zosteriform pattern has been described to be in few cases and to the best of our knowledge has never been described associated with a metastasis of a nasopharyngeal carcinoma. This case highlights the relevance of including cutaneous metastases in the differential diagnosis of patients with nonhealing herpes zoster-like lesions, especially in those with underlying neoplasm recently diagnosed.

Figure 1

Erythematous nodules following a metameric distribution on the chest.

Figure 2

Infiltration of deep dermis syncytial groups of large cells with vacuolated clear cytoplasm and vesicular nuclei.

Figure 3

Dermis cell with Epstein-Barr virus- (EBV-) encoded RNA (EBER).