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Cutaneous Metastases

»	How often do internal malignancies metastasize to the skin?
»	By what three routes do internal malignancies metastasize to the skin?
»	How do malignant cells invade and metastasize?
»	What are the most common cancers that metastasize to the skin in women?
»	What are the most common cancers that metastasize to the skin in men?
»	Do metastases to the skin typically occur in random patterns?
»	Describe the most common presentations of malignancies metastatic to the skin.
»	What is alopecia neoplastica?
»	What is a Sister Mary Joseph’s nodule?
»	Which tumors usually present as a Sister Mary Joseph’s nodule?
»	Does basal cell carcinoma ever metastasize?
»	How do you diagnose a cutaneous metastasis?
»	What is the prognosis of a patient with a cutaneous metastasis?

How often do internal malignancies metastasize to the skin?

Cutaneous metastases of internal malignancies are relatively uncommon. An autopsy study including 7500 patients with internal malignancies demonstrated cutaneous metastases in 9% of patients. Most cases occur late in the course of the disease, but cutaneous metastasis may also be the initial presentation of an internal malignancy.

Lookingbill DP, Spangler N, Helm KF: Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients, J Am Acad Dermatol 29:228–236, 1993.