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

HNSCC: head and neck SCC SCC: squamous cell carcinoma SSS: secondary SCC of the skin INTRODUCTION 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. 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. Of note, SSS may also be caused by primary cancers of the lung, bladder, vulva, and cervix. 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. 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.