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Öğe Exceptional Variant with Distant Cutaneous Metastasis as the First Clinical Sign in Gastric Signet-Ring Carcinoma(Springer, 2022) Bulut, Ezgi; Tastekin, Ebru; Topuz, Canberk; Ozturk, Sevgi; Gokyer, AliObjective Skin metastases from gastric cancer are rare and usually occur very late in the course of the disease. The most common metastatic sites liver, the peritoneal surfaces, and the non regional or distant lymph nodes. Case report In this case we report the short-term survival of a 67-year-old man complined of multiple nodular lesions in various part of his skin. Histology showed a metastatic signet ring cell adenocarsinoma. Esophagogastroduodenoscopy was performed and a crater- like ulcer, about 3 cm in diameter, was observed on the anterior part of the stomach corpus distal. A biopsy specimen was obtained, and histopathological findings were consistent with gastric signet-ring cell carcinoma. XELOX chemotherapy regimen was initiated for the patient. Conclusion Skin metastasis of gastric adenocarcinoma is a rare condition with a poor prognosis. It may be the first manifestation of a clinically silent visceral cancer or may represent a recurrence of an internal malignancy.Öğe Multiple Clinical Manifestations of Lichenoid Spectrum: A Patient with Frontal Fibrosing Alopecia, Lichen Planus Pigmentosus, and Nail Lichen Planus(Karger, 2022) Sarikaya Solak, Sezgi; Sezer, Burak Emre; Anzerlioglu, Mete; Tokmak, Zeynep; Topuz, CanberkIntroduction: Frontal fibrosing alopecia (FFA) is characterized by irreversible, symmetrical band-like hair loss in the frontotemporal region. Lichen planus pigmentosus (LPP) is a variant of lichen planus (LP) that presents with hyperpigmented macules and patches predominantly in sun-exposed areas. Nail LP is a subtype of LP that can be present alone or with other forms of LP. Case Report: We report a rare case of a 59-year-old woman presenting with symmetrical, gray-brown, hyperpigmented lesions on her neck and face, band-like alopecia in the frontotemporal region, severe onycholysis in two fingernails, and prominent longitudinal ridging in all fingernails. Clinical, dermoscopic, and histological findings established a diagnosis of FFA associated with LPP and nail LP was established. Discussion/Conclusion: In recent years, it has been established that FFA can be associated with LPP and it is thought to be a variant of lichen planopilaris. Nail involvement is rarely reported in FFA or LPP. To our knowledge, the presence of the three conditions in the same patient has not been previously reported. Although rare we would like to emphasize the importance of a careful examination of the nails in patients with FFA and/or LPP to prevent irreversible nail changes.