Dermatology: Practical and Conceptual


Image Letter  |  Dermatol Pract Concept 2020;10(1):e2020007 1

Dermatology Practical & Conceptual

Zosteriform Cutaneous Distant Metastases as  
Onset of Relapsing Melanoma

Daniel Morgado-Carrasco,1 Clara Fernández-Sartorio,1 Cristina Carrera1

1 Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, and Centro de Investigaciones en Red 

de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Spain

Key words: melanoma, zosteriform metastases, cutaneous metastases, melanoma metastases

Citation: Morgado-Carrasco D, Fernández-Sartorio C, Carrera C. Zosteriform cutaneous distant metastases as onset of relapsing 
melanoma. Dermatol Pract Concept. 2020;10(1):e2020007. DOI: https://doi.org/10.5826/dpc.1001a07

Accepted: September 13, 2019; Published: December 31, 2019

Copyright: ©2019 Morgado-Carrasco et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are 
credited.

Funding: None.

Competing interests: The authors have no conflicts of interest to disclose.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Cristina Carrera, MD, PhD, Melanoma Unit, Department of Dermatology, Hospital Clínic de Barcelona, Barcelona, 
Spain. Email: ccarrera@clinic.cat

Case Presentation

A 66-year-old man with a history of an ulcerated melanoma 

on the lumbar region, Breslow index 2.9 mm, with regional 

lymph node involvement, presented with pinkish papules on 

his forehead 5 months after the initial surgery. The lesions 

rapidly evolved into multiple coalescent papulonodules 

forming a zosteriform plaque on his forehead (Figure 1). 

Skin biopsy confirmed the diagnosis of cutaneous melanoma 

metastases.

Teaching Point

Zosteriform metastases are rare, with only about 60 cases 

reported, and melanoma is one of the most frequent neo-

plasms implicated [1,2]. Physicians should suspect this infre-

quent form of skin metastases even when lesions are distant 

from the primary site.

References

1. Savoia P, Fava P, Deboli T, Quaglino P, Bernengo MG. Zosteriform 

cutaneous metastases: a literature meta-analysis and a clinical 

report of three melanoma cases. Dermatol Surg. 2009;35(9):1355-

1363.

2. Chaudhary S, Bansal C, Husain A. Literature meta-analysis of 

zosteriform cutaneous metastases from melanoma and a clini-

co-histopathological report from India. Ecancermedicalscience. 

2013;7:324.

Figure 1. Metastatic melanoma. Multiple coalescent papulonodules 

forming a zosteriform plaque on the forehead.

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