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Case Reports

Abstract

Carcinoma erysipeloides (CE) is a rare pattern of skin metastasis originating from an internal malignancy via lymphatic spread. CE can have diverse cutaneous manifestations such as patches, papules, or erythematous plaques mimicking cellulitis. Lesions frequently appear on the abdomen and the breast, and underlying breast cancer is the most common source. However, due to its infrequent occurrence, the spectrum of malignancies that can present as CE is understudied.

We report an unusual case of CE stemming from gastric adenocarcinoma in a 68-year-old female. The patient sought medical attention for a persistent pruritic rash extending from her left ear to her neck, unresponsive to topical steroid treatment. Cutaneous examination revealed pink patches and thin eczematous plaques across her left facial area, neck, and chest. Histological analysis of a skin biopsy from the affected region identified small clusters of atypical epithelial cells within the superficial dermal vessels, expressing cytokeratin 7 but not cytokeratin 20. Concurrently with the skin lesions, she was diagnosed with gastric adenocarcinoma with signet ring morphology, matching immunophenotype and metastasis to the omentum.

This case underscores the rarity of gastric adenocarcinoma as a CE source, presenting with an inflammatory rather than more typical nodular appearance and involving an atypical site on the face and neck. This emphasizes the importance of heightened clinical and pathological vigilance to facilitate early detection of metastatic diseases.