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Zosteriform Cutaneous Distant Metastases as Onset of Relapsing Melanoma

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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.

Figure 1 .

Metastatic melanoma. Multiple coalescent papulonodules forming a zosteriform plaque on the forehead.

Teaching Point

Zosteriform metastases are rare, with only about 60 cases reported, and melanoma is one of the most frequent neoplasms implicated [ 1 , 2 ] . Physicians should suspect this infrequent form of skin metastases even when lesions are distant from the primary site.


  1. Zosteriform cutaneous metastases: a literature meta-analysis and a clinical report of three melanoma cases Savoia P, Fava P, Deboli T, Quaglino P, Bernengo MG. Dermatol Surg.2009;35(9):1355-1363.
  2. Literature meta-analysis of zosteriform cutaneous metastases from melanoma and a clinico-histopathological report from India Chaudhary S, Bansal C, Husain A. Ecancermedicalscience.2013;7:324.

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