A Bumpy Course: Nodules Along a Mastectomy Scar

Published:January 31, 2017DOI:
      The skin eruption on a patient with a history of cancer was not nearly as innocuous as she assumed. When a 54-year-old woman from Mexico presented with a 1-month history of erythematous, nontender, nonpruritic papules and nodules on the right side of her chest wall, she attributed the skin lesions to a spider bite. On examination, the largest of the lesions exhibited a well-circumscribed border and central ulceration (Figures 1 and 2). A review of systems was otherwise negative.
      Figure thumbnail gr1
      Figure 1The patient had erythematous papules and nodules along the chest wall at the site of a prior mastectomy incision. Note that the largest of the lesions exhibits central ulceration.
      Figure thumbnail gr2
      Figure 2The papules and nodules were neither tender nor pruritic.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Lookingbill D.P.
        • Spangler N.
        • Helm K.F.
        Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients.
        J Am Acad Dermatol. 1993; 29: 228-236
        • Hu S.C.
        • Chen G.S.
        • Wu C.S.
        • Chai C.Y.
        • Chen W.T.
        • Lan C.C.
        Rates of cutaneous metastases from different internal malignancies: experience from a Taiwanese medical center.
        J Am Acad Dermatol. 2009; 60: 379-387
        • Schwartz R.A.
        Cutaneous metastatic disease.
        J Am Acad Dermatol. 1995; 33: 161-182
        • Hussein M.R.
        Skin metastasis: a pathologist's perspective.
        J Cutan Pathol. 2010; 37: e1-e20
        • Lookingbill D.P.
        • Spangler N.
        • Sexton F.M.
        Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients.
        J Am Acad Dermatol. 1990; 22: 19-26
        • Ahmed M.
        Cutaneous metastases from breast carcinoma.
        BMJ Case Rep. 2011; 2011: 1-3
        • Marneros A.G.
        • Blanco F.
        • Husain S.
        • Silvers D.N.
        • Grossman M.E.
        Classification of cutaneous intravascular breast cancer metastases based on immunolabeling for blood and lymph vessels.
        J Am Acad Dermatol. 2009; 60: 633-638
        • Cox S.E.
        • Cruz Jr., P.D.
        A spectrum of inflammatory metastasis to skin via lymphatics: three cases of carcinoma erysipeloides.
        J Am Acad Dermatol. 1994; 30: 304-307
        • Schoenlaub P.
        • Sarraux A.
        • Grosshans E.
        • Heid E.
        • Cribier B.
        Survival after cutaneous metastasis: a study of 200 cases.
        Ann Dermatol Venereol. 2001; 128: 1310-1315
        • Nelli F.
        • Moscetti L.
        • Natoli G.
        • et al.
        Gemcitabine and carboplatin for pretreated metastatic breast cancer: the predictive value of immunohistochemically defined subtypes.
        Int J Clin Oncol. 2013; 18: 343-349