BMJ Case Reports 2018; doi:10.1136/bcr-2017-222923
  • Images in…

Lymphangitis carcinomatosa of a cutaneous squamous cell carcinoma

  1. Koen Dirk Quint
  1. Department of Dermatology, LUMC, Leiden, The Netherlands
  1. Correspondence to Dr Koen Dirk Quint, k.d.quint{at}
  • Accepted 28 January 2018
  • Published 8 February 2018


An 83-year-old woman presented with erythema, papules and nodules on the left upper arm (figure 1A). She was treated with antibiotics by her general practitioner, with no disease response. Eight months earlier a 2.5 cm poorly differentiated primary cutaneous squamous cell carcinoma of the left preauricular area, with metastases to the regional lymph nodes, was staged T2N2M0 (tumour, node, metastases). She was treated with radical tumour resection, parotidectomy, and levels 2, 3 and 5 lymph node dissection, followed by postoperative radiotherapy. A total body skin examination was performed. On the left upper arm and adjacent to the axillary sulcus, a poor demarcated area of erythema with papules and nodules was noted. …

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