Figure 4. Carcinoma en cuirasse mimicking scleroderma, carcinoma erysipelatoides mimicking erysipelas, and zosteriform cutaneous metastases mimicking varicella-zoster virus infection on the chest, abdomen, and flanks of a woman with invasive ductal carcinoma of the left breast.

Distant (A and B) and closer (C and D) lateral views of the right side (A and C) and left side (B and D) of the chest, abdomen, and flank of a woman with triple-negative invasive left breast ductal carcinoma who has developed multiple patterns of breast cancer cutaneous metastases. The skin overlying her entire chest is firm, indurated, and bound down (black rectangle); these are the sclerodermoid changes of carcinoma en cuirasse. Erythematous macular patches (black ovals) mimicking erysipelas are present in the superior and inferior borders of her skin lesions; these are the cellulitis-like changes of carcinoma erysipelatoides. Eroded and crusted plaques with some pseudo-vesicular papules and nodules, occupying multiple consecutive dermatomes (between the black arrows), extend bilaterally from the mid-abdomen onto the lateral flanks; these are the herpes zoster-like changes of zosteriform cutaneous metastases. Skin biopsies showed metastatic tumor cells (consistent with breast carcinoma) between dermal collagen bundles and filling lymph vessels in the dermis.