A sinister rash in a lady with breast malignancy

Cutaneous metastasis may be the first presentation of an undiagnosed malignancy or a relapse of a previously treated malignancy. We describe a case of a 64-year-old lady with cutaneous metastases from breast carcinoma, who presented with two uncommon rash morphology-carcinoma erysipeloides (CE) and annular erythema. Histopathological examination showed infiltration of neoplastic cells in the dermal lymphatics and staging CT showed distant metastases. She is currently on palliative chemotherapy. A high index of suspicion and early referral to a dermatologist is crucial for early diagnosis for a patient who presents with an inflammatory skin lesion that is refractory to treatment, particularly if the patient has a previous history of malignancy.