Abstract
An 80-year-old woman developed vesicle-like papules refractory to antiviral drugs on the left lower limbs with chronic lymphedema. The lesion progressed to the right side of the chest and abdomen. The biopsy specimens showed that the nests consisting of tumour cells with atypical nuclei were distributed from the intra-epidermis to the middle dermis. Immunohistochemical findings suggested that the tumour cells might be derived from squamous cell carcinoma of any internal organs. However, neck to pelvis computed tomography showed no lesions compatible with primary neoplasms, although upper gastrointestinal and colonic endoscopy could not be performed. In addition, increased levels of serum CA125 and ProGRP made it difficult even to speculate about the primary origin. Therefore we diagnosed our case as zosteriform cutaneous metastasis derived from carcinoma of unknown primary origin. A biopsy should be performed for zosteriform cutaneous lesions on chronic lymphedema, because the lesions may be neoplasm, not inflammatory change.[Skin Cancer (Japan) 2014 ; 29 : 264-269]
