A 47-year-old white female patient with known prior history of estrogen-receptor-positive invasive ductal carcinoma of the right breast, post-bilateral mastectomy, and prolonged history of systemic lupus erythematous (SLE) and scleroderma on long-term therapy with hydroxychloroquine presented to the head and neck surgery (ENT) clinic after a biopsy from the right anterior maxilla was positive for invasive melanoma. Here, ESR1 is linked to scleroderma.