Secondary alopecia neoplastica – the first metastasis of the breast cancer

On examination, in parietal region two alopecic plaques, measuring 4x5cm i 2x2cm, slightly sclerotic, erythematous, shiny, with rare crusts and telangiectasia were seen (Figure 1a). Routine laboratory analyses and tumor markers( CA 128, CA 15-3, CEA ) were within normal limits, chest x-ray and ultrasound of the abdomen showed no pathological lesions. Histopathology of the by opted skin lesion revealed atypical cells that form infiltrative cords, small lobules and ducts throughout the dermis. These cells exhibited marked pleomorphism with high nuclear/ cytoplasmic ratio (Figure 2). Metastatic breast carcinoma was confirmed.