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Yamada A, Umemoto N, Demitsu T, Kitamura O. Acrokeratosis neoplastica (Bazex syndrome): Report of two cases and literature review. Heliyon 2024; 10:e26411. [PMID: 38434419 PMCID: PMC10906289 DOI: 10.1016/j.heliyon.2024.e26411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
The skin often reflects the presence of internal diseases. Acrokeratosis neoplastica (Bazex syndrome) is a unique skin manifestation characterized by its erythematous hyperkeratosis with yellowish, adherent scales on the palm, sole, or other acral locations. There is a potentially high association between Bazex syndrome and malignant pathology, especially squamous cell carcinomas (SCC). To date, various skin conditions have been recognized as diagnostic indicators of insidious malignancies. The recognition of paraneoplastic dermatoses has a strong potential for prompt cancer detection and early therapeutic intervention. Here we describe clinical and forensic cases of Bazex syndrome that are associated with SCC of the glottis and lung. Bazex syndrome has been reported to be associated with a variety of cancers in addition to SCC. We review the clinical manifestations of Bazex syndrome and include updated knowledge on disease pathogenesis.
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Affiliation(s)
- Atsushi Yamada
- Department of Legal Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
- Department of Dermatology, Jichi Medical University Saitama Medical Center, 1-847, Amanuma-cho, Omiya-ku, Saitama, 330-0834, Japan
| | - Naoka Umemoto
- Department of Dermatology, Jichi Medical University Saitama Medical Center, 1-847, Amanuma-cho, Omiya-ku, Saitama, 330-0834, Japan
| | - Toshio Demitsu
- Department of Dermatology, Jichi Medical University Saitama Medical Center, 1-847, Amanuma-cho, Omiya-ku, Saitama, 330-0834, Japan
| | - Osamu Kitamura
- Department of Legal Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
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Yamada A, Umemoto N, Shimoyamada H, Demitsu T, Kitamura O. Deck-chair sign as a diagnostic clue for insidious T-cell lymphoma: An autopsy case of mycosis fungoides. Leg Med (Tokyo) 2023; 65:102326. [PMID: 37778204 DOI: 10.1016/j.legalmed.2023.102326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
Skin reflects the presence of systemic diseases, leading to an unexpected diagnosis of insidious diseases. Deck-chair sign is a unique skin eruption characterized by widespread erythematous papules that become erythrodermic with spare skin folds. An association between the deck-chair sign and malignancies, especially hematological neoplasms, has been suggested. We report a forensic case of mycosis fungoides unexpectedly diagnosed in the presence of a deck-chair sign. Mycosis fungoides is representative of cutaneous T-cell lymphomas. Here, we successfully demonstrated the feasibility of analyzing mycosis fungoides in a forensic autopsy case using basic histopathology and serology. We emphasize that the underlying malignancy should be primarily considered in cadavers with a positive deck-chair sign and review current reports about this characteristic skin manifestation.
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Affiliation(s)
- Atsushi Yamada
- Department of Legal Medicine, Kyorin University, Faculty of Medicine, Tokyo, Japan; Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
| | - Naoka Umemoto
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Kyorin University, Faculty of Medicine, Tokyo, Japan
| | - Toshio Demitsu
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Osamu Kitamura
- Department of Legal Medicine, Kyorin University, Faculty of Medicine, Tokyo, Japan
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Jiménez LF, Castellón EA, Marenco JD, Mejía JM, Rojas CA, Jiménez FT, Coronell L, Osorio-Llanes E, Mendoza-Torres E. Chronic urticaria associated with lung adenocarcinoma — a paraneoplastic manifestation: A case report and literature review. World J Clin Cases 2022; 10:7553-7564. [PMID: 36157992 PMCID: PMC9353901 DOI: 10.12998/wjcc.v10.i21.7553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/07/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Urticaria is one of the most common causes of emergency room visits. It is defined as an acute inflammatory dermatosis, characterized by localized degranulation of mast cells, with consequent dermal microvascular and formation of edematous and pruritic plaques called hives. Urticaria affects the skin and tissues of the superficial mucosa. Sometimes it is accompanied by angioedema, which is characterized by deeper edema of the dermis and subcutaneous cellular tissue known as the urticarial-angioedema syndrome. About 15%-25% of the general population has suffered at least one type of urticaria at some point during their lifetime and hyperpermeability estimated at 7.6%-16% and has experienced acute urticaria that is usually self-limited and spontaneously resolves without requiring medical attention.
CASE SUMMARY We present the case of a young male patient who was referred to our department with a clinical picture of 4 mo of pruritus associated with hives of variable sizes, irregular borders, with interlesional confluence, that were non-painful, without involvement of the palms and soles of the feet but with a tendency to progression in a generalized manner. He had multiple emergency room visits and poor response to antihistamines and systemic corticosteroids. Imaging studies demonstrated nodules in the lower lingula segment, at the level of the greater fissure and in the anterior contour of the left anterior basal segment associated with parahiliar adenopathies in the absence of findings suggestive of infectious or autoimmune etiology. Segmental lobectomy was performed by thoracoscopy with resection of a lung nodule in the lingula and biopsy of the para-aortic mediastinal ganglion. The histopathological report showed the presence of poorly differentiated invasive adenocarcinoma with a solid morphological and acinar pattern with immunohistochemical description of lung tissue that expresses strong positive and diffuse reaction for thyroid transcription factor 1 (TTF-1) with negativity to P40 for a histopathological diagnosis of malignant epithelial neoplasia with expression of infiltrating adenocarcinoma. Spontaneous chronic urticaria is considered possibly secondary to lung adenocarcinoma.
CONCLUSION Chronic spontaneous urticaria is considered a paraneoplastic dermatosis with a controversial association in the literature. In the presented case, a young patient presented with chronic refractory urticaria and after an exhaustive clinical work-up was found to have a diagnosis of poorly differentiated lung adenocarcinoma with high expression of TTF-1. According to the Curth criteria, the urticaria presented by the patient is related to the oncological diagnosis. In addition, the high expression of TTF-1 documented in this case could be acting as an autoantigen that would cause chronic spontaneous urticaria. Further research evaluating a causal relationship between the TFF-1 protein and urticaria in lung cancer is needed.
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Affiliation(s)
- Luisa Fernanda Jiménez
- Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - Evis Adriana Castellón
- Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - Juan David Marenco
- Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - José Maria Mejía
- Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - Camilo Andrés Rojas
- Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - Franklin Torres Jiménez
- Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - Linda Coronell
- Faculty of Health Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - Estefanie Osorio-Llanes
- Faculty of Exact and Natural Sciences, Universidad Libre de Colombia, Seccional Barranquilla, Barranquilla 08000, Colombia
| | - Evelyn Mendoza-Torres
- Faculty of Health Sciences, Universidad Libre De Colombia, Seccional Barranquilla, Barranquilla 08000, Atlántico, Colombia
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Vora RV, Kota RS, Diwan NG, Jivani NB, Gandhi SS. Skin: A mirror of internal malignancy. Indian J Med Paediatr Oncol 2017; 37:214-222. [PMID: 28144085 PMCID: PMC5234155 DOI: 10.4103/0971-5851.195730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Skin manifestations are a reflection of many of the internal diseases. Sometimes, skin disease may be the only manifestation of the internal disease. Internal malignancies may give rise to a number of cutaneous manifestations through their immunological, metabolic, and metastatic consequences. Curth proposed criteria to establish a causal relationship between a dermatosis and a malignant internal disease. Malignancy can present with a plethora of cutaneous manifestations. Here, we describe in brief about various skin manifestations of internal malignancies.
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Affiliation(s)
- Rita V Vora
- Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
| | - RahulKrishna S Kota
- Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
| | - Nilofar G Diwan
- Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
| | - Nidhi B Jivani
- Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
| | - Shailee S Gandhi
- Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
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5
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Abstract
A 9-year-old castrated domestic shorthair cat was presented with a 6 week history of progressive non-pruritic alopecia, polyphagia and weight loss. A diagnosis of lymphocytic mural folliculitis was made and the cat was treated with a combination of prednisolone and ciclosporin; this produced an improvement in the alopecia but no resolution. Sixteen months after the initial assessment and diagnosis, the cat was re-evaluated for intermittent vomiting and weight loss with normal appetite. On examination the dermatopathy was still evident and a mass involving the duodenum and pancreas was present, which was diagnosed as a pancreatic carcinoma. From this case it would appear that lymphocytic mural folliculitis might be an early dermatological manifestation of pancreatic neoplasia.
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Affiliation(s)
- Remo Lobetti
- Bryanston Veterinary Hospital, Bryanston, South Africa
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Abstract
BACKGROUND Sister Mary Joseph's nodule (SMJN) represents an unusual clinical feature of metastatic deposit at the umbilicus originating from an intra-abdominal malignancy. OBJECTIVE To outline the paucity of such a condition, review the associated pathologies, and demonstrate the importance of clinical and histopathologic correlation. METHODS Case report of a 75-year-old man with vesical and prostatic cancers treated 2 years prior to presenting with an umbilical lesion. Histopathologic and radiologic examinations were performed to confirm the clinical diagnosis. RESULTS Histopathology of the umbilical biopsy revealed a carcinoma of urothelial origin, but immunohistochemistry suggested a squamous cell carcinoma. Clinically, the lesion did not support a diagnosis of primary squamous cell carcinoma; in addition, the positron emission tomographic scan revealed a captation at the ureterovesical junction that was compatible with vesical cancer relapse. CONCLUSION SMJN is a rare but typical cutaneous metastasis of internal malignancy, and its recognition is of great importance because it may be the first presenting sign in a patient with an unknown malignant disease.
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Affiliation(s)
- Sandra Davar
- Divion of Dermatolgy, CHUM-Hôpital Saint-Luc, Montreal, Quebec
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Berrady R, Baybay H, Khammar Z, Lahlou M, Lamchachti L, Gallouj S, El Hatimi A, Mernissi FZ, Bono W. Ichtyose acquise et hémopathie maligne : cinq observations. Ann Dermatol Venereol 2012; 139:9-14. [DOI: 10.1016/j.annder.2011.10.394] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 07/11/2011] [Accepted: 10/20/2011] [Indexed: 11/17/2022]
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Abstract
Taken together, the wide range of rheumatic and musculoskeletal conditions that can appear in association with cancer emphasizes that rheumatic disease is a major component of the spectrum of paraneoplastic manifestations. Although the pathogenetic mechanisms by which neoplasia causes these manifestations are only partially understood in select cases, it appears that many result from immune-mediated effects stimulated by tumor antigens of endocrine factors produced by tumors. The broad overlap in signs and symptoms of occult malignancy and systemic rheumatic disease, as well as the occurrence of distinct localized and systemic musculoskeletal and rheumatic syndromes in the presence of cancer, emphasizes the importance of considering and investigating the possibility of occult malignancy in the evaluation of patients with these symptoms. This is particularly important in older patients, those with atypical rheumatic disease, and those who do not respond appropriately to conventional immunosuppressive therapy.
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Affiliation(s)
- Judith F Ashouri
- Division of Rheumatology, Department of Medicine, University of California, San Francisco, 400 Parnassus, San Francisco, CA, USA
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9
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Ikeda N, Takahashi K, Yamaguchi Y, Inasaka M, Kuwana M, Ikezawa Z. Analysis of dermatomyositis-specific autoantibodies and clinical characteristics in Japanese patients. J Dermatol 2011; 38:973-9. [PMID: 21883412 DOI: 10.1111/j.1346-8138.2011.01262.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dermatomyositis (DM) is an idiopathic systemic inflammatory disease that is often accompanied by interstitial lung disease (ILD) or internal malignancy. New autoantibodies, anti-clinically amyopathic dermatomyositis 140 (anti-CADM-140) antibody (Ab) and anti-155/140 Ab, as well as anti-aminoacyl-tRNA synthetase (anti-ARS) Ab and anti-Mi-2 Ab, have been discovered and their utility indicated. However, the association between these autoantibodies and the clinical characteristics of DM is not fully understood, and it is unclear whether anti-155/140 Ab is "specific" to DM patients with internal malignancy. Therefore, we analyzed 55 DM patients and 18 non-DM patients with malignancy to evaluate the clinical characteristics, especially skin manifestations, in association with DM-specific autoantibodies detected by immunoprecipitation. Six patients (11%) had anti-CADM-140 Ab, nine (16%) had anti-155/140 Ab, eight (15%) had anti-ARS Ab and six (11%) had anti-Mi-2 Ab. The frequency of DM patients positive for any type of autoantibody was 53%. Among the 20 DM patients with ILD, three (15%) had both anti-CADM-140 Ab and rapidly progressive ILD, and required intensive therapy (P < 0.05). ILD found in anti-ARS Ab-positive patients did not progress rapidly. The prevalence of muscle involvement in patients with anti-CADM-140 Ab was 83%. Among the 18 DM patients with internal malignancy, four (22%) had anti-155/140 Ab, and internal malignancy was found in four cases (44%) of nine anti-155/140 Ab-positive patients. None of the non-DM patients with malignancy were positive for anti-155/140 Ab. In conclusion, the results of the present study indicate that anti-155/140 Ab is specific to DM patients with internal malignancy and that we may be able to predict prognosis of ILD and the presence of malignancy to some extent, suggesting that examination of autoantibodies in DM patients is clinically very useful. However, further investigation is needed because several findings differ from those of previous reports.
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Affiliation(s)
- Nobuaki Ikeda
- Department of Environmental Immuno-Dermatology, Yokohama City University School of Medicine, Yokohama, Japan
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10
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Almaani N, Robson A, Sarkany R, Griffiths WAD. Erythema gyratum repens associated with pityriasis rubra pilaris. Clin Exp Dermatol 2011; 36:161-4. [DOI: 10.1111/j.1365-2230.2010.03861.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Topham E. Cutaneous manifestations of cancer and chemotherapy. Clin Med (Lond) 2009; 9:375-9. [PMID: 19728518 PMCID: PMC4952512 DOI: 10.7861/clinmedicine.9-4-375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Emma Topham
- Brighton and Sussex University Hospitals NHS Trust, Brighton General Hospital.
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12
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Tzovaras V, Liberopoulos EN, Zioga A, Pavlidis N, Elisaf M. Persistent erythema multiforme in a patient with extrahepatic cholangiocarcinoma. Oncology 2008; 73:127-9. [PMID: 18337625 DOI: 10.1159/000121001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Accepted: 08/24/2007] [Indexed: 12/11/2022]
Abstract
Presented in this report is a 66-year-old male with a widespread persistent erythema multiforme mostly atypical in appearance, which was detected well before the diagnosis of underlying extrahepatic cholangiocarcinoma. The lesions regressed in response to chemotherapy, but they appeared again in connection with tumor relapse. Clinicians should recognize persistent erythema multiforme as one of the paraneoplastic dermatoses and efforts should be made to detect internal malignancies in patients with these skin lesions.
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Affiliation(s)
- Vasilios Tzovaras
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
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Abstract
PURPOSE A skin finding may be an indicator of internal malignant diseases. In this report, we investigated the skin findings of the cases who have had internal malignancy within the last 1 month. PATIENTS AND METHODS Seven hundred cases who were diagnosed as internal malignancy and who did not have any treatment for the malignancy were enrolled in our study between February 2002 and September 2003. A form was completed for all of the cases, including name, surname, and the carcinoma type. All cases were examined in detail, and the observed skin findings or dermatosis was recorded. RESULTS The most frequent skin findings among the cases were tinea pedis/onychomycosis, followed by xerosis and pruritus. The skin findings in terms of frequency were determined mostly in hematological malignancies (68.96%). CONCLUSION We would like to emphasize that the skin is an indicator of the functions of internal organs and their disorders.
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Affiliation(s)
- Arzu Kiliç
- Ankara Numune Education and Research Hospital, 2nd Dermatology Clinic, Ankara, Turkey.
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14
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Slee PHTJ, van der Waal RIF, Schagen van Leeuwen JH, Tupker RA, Timmer R, Seldenrijk CA, van Steensel MAM. Paraneoplastic hypertrichosis lanuginosa acquisita: uncommon or overlooked? Br J Dermatol 2007; 157:1087-92. [PMID: 17941940 DOI: 10.1111/j.1365-2133.2007.08253.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Acquired hypertrichosis lanugo-type or hypertrichosis lanuginosa acquisita (HLA) is often associated with metabolic and endocrine disorders and use of certain drugs. The occurrence of HLA with malignancy was first noted in 1865, and it has since been described in 56 patients as a paraneoplastic syndrome both in women and in men. Sometimes HLA occurs concurrent with acanthosis nigricans, papillary hypertrophy of the tongue, and glossitis. The predominance of female cases is striking. Malignancy-associated HLA seems to occur especially in the age group 40-70 years. In women with HLA the most frequent malignancy is colorectal cancer, followed in order by lung cancer and breast cancer; in men lung cancer is the malignancy most frequently associated with HLA, followed by colorectal cancer. In 3 years we saw 10 patients with HLA, in whom the malignancy was usually metastasized. Only one patient had local disease; after removal of the primary tumour it took 2 years before the lanugo hair recurred. The aetiology of the syndrome is not clear: no specific hormonal or biochemical abnormalities have been identified as yet. The difference between hirsutism and lanugo-type hypertrichosis is discussed. It is stressed that the appearance of lanugo-type hypertrichosis in body areas previously perceived by patients as 'hairless' is highly indicative of internal malignancy.
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Affiliation(s)
- P H T J Slee
- Department of Internal Medicine, St Antonius Hospital, PO Box 2500, 3430 EM Nieuwegein, The Netherlands.
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15
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Bazex J, ElSayed F, Cadilhac H, Gorguet B, Soulier M, Durand D. Acrokeratosis paraneoplastica (Bazex syndrome) and inappropriate antidiuretic hormone secretion associated with epidermoid and anaplastic bronchial cancer. J Eur Acad Dermatol Venereol 2006. [DOI: 10.1111/j.1468-3083.1994.tb00413.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Chung VQ, Moschella SL, Zembowicz A, Liu V. Clinical and pathologic findings of paraneoplastic dermatoses. J Am Acad Dermatol 2006; 54:745-62; quiz 763-6. [PMID: 16635655 DOI: 10.1016/j.jaad.2004.06.051] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2004] [Indexed: 12/21/2022]
Abstract
UNLABELLED Paraneoplastic dermatoses comprise a heterogeneous group of noninherited skin conditions that manifest internal malignancy. Familiarity with paraneoplastic dermatoses is important to both clinician and pathologist alike, as recognition of such a condition offers opportunity for early diagnosis and treatment of internal malignancy; monitoring for tumor recurrence; and insight into pathophysiology which may yield possible clues to treatment. Herein are reviewed 16 of the best established paraneoplastic dermatoses that display distinctive clinical and pathologic findings. LEARNING OBJECTIVE At the conclusion of this leaning activity, participants should be able to recognize, diagnose, and describe the clinical and pathologic findings of paraneoplastic dermatoses.
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Affiliation(s)
- Vinh Q Chung
- Harvard Medical School, Boston, Massachusetts, USA
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17
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Shiotani A, Sakurane M, Furukawa F. Helicobacter pylori-positive patients with pruritic skin diseases are at increased risk for gastric cancer. Aliment Pharmacol Ther 2004; 20 Suppl 1:80-4. [PMID: 15298610 DOI: 10.1111/j.1365-2036.2004.01977.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Helicobacter pylori infection has been implicated as a possible cause of extraintestinal disorders such as skin diseases. A number of case reports describe patients with skin diseases, such as prurigo nodularis, that are associated with gastric cancer. AIM The aim of this study was to examine the prevalence of H. pylori infection and the incidence of gastric cancer in patients with pruritic skin diseases. METHODS The patients were examined for circulating specific IgG antibodies against H. pylori in sera using ELISA. H. pylori-positive patients who were more than 40 years old underwent endoscopic screening for gastric cancer. RESULTS We examined 134 patients with pruritic skin diseases, including 55 cases of cutaneous pruritus, 21 cases of prurigo chronica multiforme, 15 cases of nummular dermatitis and 43 cases of chronic urticaria. Early gastric cancer was detected in 2/36 (5.6%) patients with cutaneous pruritus and 3/16 (18.8%) with prurigo chronica multiforme. The prevalence of early gastric cancer was 5.6%, which was much higher than that among patients undergoing general endoscopic screening for gastric cancer. CONCLUSIONS These results suggest that H. pylori-positive patients with pruritic skin diseases may be at increased risk for development of gastric cancer, and endoscopic screening in such patients is recommended.
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Affiliation(s)
- A Shiotani
- Health Administration Center, Wakayama University, Japan.
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19
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Cakmak O, Seçkin D, Ceken I, Yilmaz I, Akkuzu B, Ozluoglu L. Bullous pemphigoid associated with parotid carcinoma. Otolaryngol Head Neck Surg 2002; 127:354-6. [PMID: 12402019 DOI: 10.1067/mhn.2002.128603] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Ozcan Cakmak
- Department of Otorhinolaryngology, Baskent University Faculty of Medicine, Adana Hospital, Turkey.
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20
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Abstract
Skin manifestations of systemic disease and malignancy are protean. The recognition of a potentially paraneoplastic dermatosis as such must prompt an investigation for occult malignancy. Lack of familiarity with cutaneous clues of internal malignancy may delay diagnosis and treatment of cancer. It is important to consider a paraneoplastic process in the differential diagnosis of a number of eruptive and treatment-resistant dermatoses. These dermatoses may be the first sign of an occult neoplasm. Their recognition may assist in cancer detection and the swift induction of appropriate therapy.
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Affiliation(s)
- Sarah Boyce
- Department of Dermatology, University of Alabama at Birmingham, EFH, Suite 414, Birmingham, AL 35294, USA
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21
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Arnold J, Berens N, Bröcker EB, Goebeler M. Recurrent angio-oedema and solitary molluscum contagiosum as presenting signs of non-Hodgkin's B-cell lymphoma. Br J Dermatol 2002; 146:343-4. [PMID: 11903266 DOI: 10.1046/j.1365-2133.2002.4653_15.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Braun-Falco O, Plewig G, Wolff HH, Burgdorf WHC. Paraneoplastic Markers and Syndromes. Dermatology 2000. [DOI: 10.1007/978-3-642-97931-6_65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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23
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Abstract
It is clear that cutaneous lesions of metabolic epidermal necrosis in the dog can occur either with a demonstrable glucagon-secreting tumor or with hepatic disease without any detectable glucagonoma. Additional clinical case reports of the disease in cats are needed to better characterize the disease in this species. The lesions of NME-MEN may not represent a specific physiological mechanism of cutaneous disease but instead a pathophysiological process that can be triggered by several systemic metabolic abnormalities. The fact that NME is observed in association with a variety of conditions supports the theory that an overall metabolic derangement results in the rash. The prognosis for canine MEN is poor; however, some affected dogs have been maintained for many months with dietary management. High-quality protein diets such as Hill's Prescription Diet a/d (Hill's Pet Products) or other "recovery" diets may be helpful. Zinc and essential fatty acid supplementation may help some patients. Dietary supplementation with cooked egg yolks may be helpful. It is prudent to avoid corticosteroids in these cases, as development of diabetes mellitus worsens the prognosis. Histopathological examination of the pancreas coupled with determination of plasma glucagon may help define the characteristics of GS versus HS in dogs. It is possible that some dogs diagnosed with MEN-HS may have an undetected pancreatic tumor. Although the hepatic ultrasound findings in dogs with MEN-HS are becoming well characterized, it is possible for dogs with pancreatic neuroendocrine tumors to also have abnormal hepatic ultrasonography. As the presence of MEN and hepatic disease does not necessarily rule out the presence of a pancreatic tumor, prospective studies correlating plasma glucagon levels with pancreatic histopathology in cases of MEN-GS versus MEN-HS seem warranted.
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Affiliation(s)
- K P Byrne
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, USA
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Tasker S, Griffon DJ, Nuttall TJ, Hill PB. Resolution of paraneoplastic alopecia following surgical removal of a pancreatic carcinoma in a cat. J Small Anim Pract 1999; 40:16-9. [PMID: 10092037 DOI: 10.1111/j.1748-5827.1999.tb03248.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 13-year-old female neutered domestic longhaired cat was presented with a five-month history of progressive weight loss and bilaterally symmetrical alopecia of the ventrum, limbs and perineum. The alopecic skin had a shiny appearance and hair in the non-alopecic areas was easily epilated. Fine needle aspirate cytology of a palpable cranial abdominal mass revealed it to be of epithelial or glandular origin. A pancreatic mass was excised by left pancreatectomy during exploratory laparotomy, and histopathology and skin biopsies confirmed a diagnosis of pancreatic carcinoma with concurrent paraneoplastic alopecia. No evidence of metastases was found on liver and lymph node biopsies. At re-examination 10 weeks after surgery, the hair had fully regrown. Skin signs recurred after 18 weeks and metastatic spread of the tumour was confirmed on postmortem examination. This case confirms that paraneoplastic alopecia associated with internal malignancies is a potentially reversible process if the internal neoplasm is excised.
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Affiliation(s)
- S Tasker
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Small Animal Clinic, Summerhall
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Fariña MC, Tarín N, Grilli R, Soriano ML, Sarasa JL, Martín L, Requena L. Acquired hypertrichosis lanuginosa: case report and review of the literature. J Surg Oncol 1998; 68:199-203. [PMID: 9701215 DOI: 10.1002/(sici)1096-9098(199807)68:3<199::aid-jso13>3.0.co;2-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Acquired hypertrichosis lanuginosa is a rare cutaneous disorder usually associated with internal malignancy that consists of the development of abnormal hair growth of the lanugo type, often confined to the skin of the face and neck, although other areas also may be involved. We report on a 66-year-old woman with a metastatic ductal infiltrating carcinoma of the breast who developed growth of fine lanugo type hair on her face and progressive growth of the hair of eyebrows and eyelashes. We review the literature on this uncommon paraneoplastic cutaneous disorder emphasizing the pathogenic mechanisms that have been proposed to explain the striking overgrowth of lanugo type hair.
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Affiliation(s)
- M C Fariña
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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Pascal-Tenorio A, Olivry T, Gross TL, Atlee BA, Ihrke PJ. Paraneoplastic alopecia associated with internal malignancies in the cat. Vet Dermatol 1997; 8:47-52. [PMID: 34645026 DOI: 10.1111/j.1365-3164.1997.tb00263.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Aurea Pascal-Tenorio
- *Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Thierry Olivry
- *Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA
| | | | | | - Peter J Ihrke
- §Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
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27
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Abstract
A 79-year-old man in a cancer-prone family developed disseminated seborrheic keratoses over his trunk and extremities over a few decades without rapid increase. His son, mother, and one of his brothers, who died of gastric cancer, also had numerous seborrheic keratoses for a long time. He had a biliary tract cancer. Histologic examination showed hyperproliferation of basaloid cells branching downwards, as if induced by surrounding stroma. No decrease of the number of seborrheic keratoses after surgical operation has been observed. Examination for the localization of epidermal growth factor receptor (EGF-R) and HER-2/neu oncoprotein by immunohistochemistry revealed positive staining on the epithelial strands branching downwards on the specimens of seborrheic keratoses. A different pattern of expression was demonstrated in normal seborrheic keratosis. These findings suggest that some unidentified growth factors may be involved in the induction of visceral and/or cutaneous neoplasms in this family.
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Affiliation(s)
- T Yamamoto
- Department of Dermatology, Tsuchiura Kyodo General Hospital, Ibaraki, Japan
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Abraham Z, Glück Z, Lahat N, Kinarty A. Sebaceous adenomas, squamous cell carcinoma and skin infections in a patient with carcinoma of the colon, rectum and bladder. J Dermatol 1995; 22:939-42. [PMID: 8648002 DOI: 10.1111/j.1346-8138.1995.tb03950.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Sebaceous adenomas and squamous cell carcinoma developed in a male patient in addition to viral, mycotic and bacterial infections, several years after the removal of three malignant tumors from his lower gastrointestinal and urinary tract. Skin tests with trichophytin, candidin, and mixed bacteria were negative. Various aspects regarding cutaneous changes associated with colorectal and bladder carcinomas are discussed.
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MESH Headings
- Adenocarcinoma, Mucinous/complications
- Adenocarcinoma, Mucinous/surgery
- Adenocarcinoma, Sebaceous/etiology
- Adenocarcinoma, Sebaceous/pathology
- Adenocarcinoma, Sebaceous/physiopathology
- Aged
- Candidiasis, Cutaneous/etiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/physiopathology
- Carcinoma, Transitional Cell/complications
- Carcinoma, Transitional Cell/surgery
- Colorectal Neoplasms/complications
- Colorectal Neoplasms/surgery
- Herpes Zoster/etiology
- Humans
- Male
- Skin Diseases, Bacterial/etiology
- Skin Diseases, Infectious/etiology
- Skin Diseases, Infectious/pathology
- Skin Diseases, Infectious/physiopathology
- Skin Diseases, Viral/etiology
- Skin Neoplasms/etiology
- Skin Neoplasms/physiopathology
- Skin Tests
- Tinea/etiology
- Urinary Bladder Neoplasms/complications
- Urinary Bladder Neoplasms/surgery
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Affiliation(s)
- Z Abraham
- Department of Dermatology, Reish Policlinic, Haifa, Israel
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29
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Caux F, Lebbe C, Thomine E, Benyahia B, Flageul B, Joly P, Rybojad M, Morel P. Erythema gyratum repens. A case studied with immunofluorescence, immunoelectron microscopy and immunohistochemistry. Br J Dermatol 1994; 131:102-7. [PMID: 8043400 DOI: 10.1111/j.1365-2133.1994.tb08465.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We report a patient with erythema gyratum repens (EGR), in whom a bronchial carcinoma was found. Direct immunofluorescence revealed granular deposits of immunoglobulins at the basement membrane zone (BMZ) in the skin, and in the lung tumour. Direct immunoelectron microscopy showed that the immune deposits were localized just beneath the lamina densa. Indirect immunofluorescence revealed circulating anti-BMZ antibodies. Immunohistochemical staining, using anti-transforming growth factor-beta, anti-epidermal growth factor receptor, anti-vimentin and anti-alpha-actin, was found to be more intense in the lesional skin and the lung tumour than in normal tissues. Possible mechanisms in the pathogenesis of EGR are discussed.
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Affiliation(s)
- F Caux
- Service de Dermatologie, Hôpital Saint-Louis, Paris, France
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30
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Fusaro RM, Lynch HT. Conceptual differences on the occurrence of internal malignancies in the FAMMM syndrome. J Am Acad Dermatol 1994; 30:672-4. [PMID: 8157805 DOI: 10.1016/s0190-9622(09)80128-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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