An unusual acneiform presentation representing secondary squamous cell carcinoma of the skin

Metastatic squamous cell carcinoma (SCC) to the skin, also known as secondary SCC of the skin (SSS), is a rare entity that represents advanced disease and carries a poor prognosis.1, 2 The most commonly reported primary sources for metastatic SCC to the skin are head and neck cancers of the larynx, oropharynx, tongue, epiglottis, esophagus, and nasopharynx.1, 2, 3, 4 Of note, SSS may also be caused by primary cancers of the lung, bladder, vulva, and cervix.3, 4 SSS originating from head and neck SCC (HNSCC) typically metastasize regionally to the neck, face, and scalp, while less commonly metastasizing to sites below the neck.1, 2 We present a case of distant SSS of the chest in a patient with a history of 2 invasive SCCs of the oropharynx several years prior.