A retrospective review of cutaneous metastases at the National Skin Centre Singapore.

Background/objectives: Cutaneous metastases occur in up to 10% of all visceral malignancies. This study aims to determine the clinico-epidemiological characteristics of patients diagnosed with cutaneous metastases at a leading Asian tertiary dermatological centre.

Methods: A retrospective chart review was carried out on all patients diagnosed with cutaneous metastases from 2001 to 2010, identified through the National Skin Centre's clinical and histological databases.

Results: In all, 35 patients were diagnosed with cutaneous metastases at a mean age of 65 years, with a female: male ratio of 3:2 and with most (97%) being Chinese. Cutaneous metastases were the first presentation of cancer in 34% of patients (n = 12). The two commonest primaries were breast (49%, n = 17) and lung (9%, n = 3). Most had cutaneous metastases on the chest (37%, n = 13) followed by the pelvis (17%, n = 6) and 20% (n = 7) had skin lesions on multiple sites. Clinically, 46% of patients (n = 16) presented with nodule(s), 26% (n = 9) with plaque(s) and 20% (n = 7) with heterogeneous morphologies. Cutaneous metastases were suspected in 72% of patients (n = 25), attributed to clinical features (46%, n = 16) or the presence of active metastatic disease elsewhere (26%, n = 9). All lesions appeared dermal in origin.

Conclusions: Cutaneous metastases are highly variable in presentation and a high index of suspicion is required for prompt diagnosis, especially in patients with a history of cancer, regardless of stage of treatment of the primary tumour.