Dermal Metastasis From Head and Neck Squamous Cell Carcinoma: Systematic Review and Pooled Analysis

Objective Dermal metastasis from head and neck squamous cell carcinoma (HNSCC) is a rare and poorly understood manifestation of advanced disease, historically linked to poor prognosis. This systematic review aims to better characterize the clinical associations, treatment paradigms, and survival outcomes associated with this entity. Data Sources PubMed, Embase, and Scopus databases were systematically searched through May 1, 2025. Review Methods The protocol was registered on PROSPERO, and the systematic review was reported in accordance with PRISMA guidelines. Patient‐level data on demographics, disease characteristics, treatments, and survival outcomes were extracted from cases, and pooled analyses were conducted using logistic regression, Kaplan–Meier survival estimates, and Cox proportional hazards regression. Results Seventy‐eight studies comprising 279 cases were included. Most patients were male (83%). The majority had advanced‐stage primary disease (87%) originating in the oral cavity (42%), larynx (21%), and oropharynx (18%). Dermal metastases most often affected the neck (57%) or trunk (23%). Median survival following diagnosis was 3.5 months. The receipt of treatment was independently associated with a 45% lower hazard of death compared with no treatment (HR: 0.55; 95% CI: 0.32–0.96; p = 0.036), although no individual modality conferred a significant survival advantage. Primary tumor characteristics, anatomical location of dermal lesions, and the presence of locoregional or distant metastatic disease were not predictive of survival. Conclusions Dermal metastasis from HNSCC signifies aggressive disease with limited survival. These findings underscore the importance of individualized patient counseling and the need for further research into effective therapeutic strategies.