Cutaneous skin lesions can include a variety of conditions such as lipoma, neurofibroma, warts, keloids, skin tags, or multiple angiomas. Neurocysticercosis, a rare presentation characterised by disseminated lesions, involves the brain, muscles, and skin.

We report the case of a 23-year-old male with no prior medical history who presented with complaints of multiple skin lesions over the past 2-3 years. These skin lesions are 3-4 centimetres in size, elevated from the skin surface, globular, soft, mobile, and non-tender, and spread through both arms, abdomen, back, and both legs. The patient visited the dermatology clinic due to the increasing number and size of lesions. From where he was referred to neurology in view of one episode of loss of consciousness.

The neurological examination revealed no obvious focal neurological deficits. Patients having well-defined multiple skin lesions, which were initially evaluated by dermatology and provisionally diagnosed as lipoma.  However, in the recent history of seizures, we ordered an MRI of the brain. To our surprise, the MRI brain scan revealed multiple well-defined cystic lesions diffusely distributed throughout the cerebral parenchyma, as well as in the subcutaneous tissue, which is suggestive of disseminated neurocysticercosis. The neurocysticerci were also found near the nape of the neck in a subcutaneous place, which consists of a skin lesion. We than order the full body MRI to look for dissemination in other body parts. The full body MRI suggest the complete dissemination of cysts into the chest, back, both arms and leg muscles and the subcutaneous plane. We also sent an excisional biopsy to confirm the diagnosis. The histopathology report also shows Taenia Solium cysts, not the lipoma.

This case highlights the clinical significance of recognising disseminated neurocysticercosis as a potentially serious but treatable condition that can present with multiple skin lesions.