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Pharyngeal-Esophageal Malignancies with Dermatologic Paraneoplastic Syndrome. Life (Basel) 2022; 12:life12111705. [PMID: 36362860 PMCID: PMC9693568 DOI: 10.3390/life12111705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/18/2022] [Accepted: 10/21/2022] [Indexed: 12/24/2022] Open
Abstract
Systemic changes often send signals to the skin, and certain neoplastic diseases of the internal organs can also trigger skin manifestations. In this article, the authors make clinical photography presentations of the patients seen at our clinic with dermatologic paraneoplastic syndromes within pharyngeal–esophageal malignancies, describe several paraneoplastic dermatoses, and also review high-quality scientific literature in order to be able to highlight the dermatological signs of pharyngoesophageal malignant tumors. The majority of our patients with paraneoplastic dermatoses, filtering for pharyngoesophageal malignancies, had esophageal neoplasms, out of whom seven were female and two were male, making esophageal cancer more common within the paraneoplastic dermatoses within pharyngoesophageal malignancies. An early recognition of paraneoplastic dermatoses can diagnose neoplasms and sequentially contribute to a better prognosis for the patient. This matter is also useful for front-line medical personnel in order to improve early diagnosis of the underlying malignancy, curative interventions with prompt therapy administration and good prognosis.
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Roser A, Pajot C, Kettani S, Michalak S, Le Clech C. [Malignant acanthosis nigricans associated with cholangiocarcinoma]. Rev Med Interne 2019; 40:750-753. [PMID: 31564378 DOI: 10.1016/j.revmed.2019.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/04/2019] [Accepted: 08/10/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Acanthosis nigricans is a dermatosis characterized by the presence of a hyperpigmented, velvety cutaneous thickening in the flexural areas, especially axillary and inguinal fossas, and lateral faces of the neck. AN is usually a benign condition but can sometimes reveal an internal malignancy corresponds to a cutaneous paraneoplasic syndrome. Literature shows a predominant association with gastric adenocarcinoma. Here, we report a rare association between AN and cholangiocarcinoma. CASE REPORT We report a 43-year-old woman who presented an extensive AN associated to a tripe palms syndrome and florid cutaneous papillomatosis. She consulted in dermatology because of the itchiness of the lesions as well as for esthetics reasons. Complementary investigations enabled to diagnose a cholangiocarcinoma without visceral metastasis and she was treated by tumor resection and chemotherapy. Consequently, a slight improvement of the skin condition and the disappearance of pruritus were observed. CONCLUSION AN should be considered as cutaneous sign either of malignancy or endocrinopathy and therefore requires further investigations. The existence of extensive lesions, pruritus, tripe palms syndrome, florid cutaneous papillomatosis or mucous lesions, associated to an AN is a sign of malignancy should be investigated urgently the early diagnosis of which can lead to a better prognosis.
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Affiliation(s)
- A Roser
- Service de dermatologie, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
| | - C Pajot
- Service de dermatologie, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - S Kettani
- Service d'anatomopathologie de l'Ouest, 4, rue Edmond-Cannelle, 49130 Les Ponts-de-Cé, France
| | - S Michalak
- Service d'anatomopathologie, CHU d'Angers, 4 rue Larrey, 49100 Angers, France
| | - C Le Clech
- Service de dermatologie, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
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Mendes GB, Zanetti G, Marchiori E. Leser-Trélat Sign Secondary to Thymic Carcinoma. ARCHIVOS DE BRONCONEUMOLOGÍA (ENGLISH EDITION) 2018; 54:286-287. [DOI: 10.1016/j.arbr.2017.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Leser-Trélat Sign Secondary to Thymic Carcinoma. Arch Bronconeumol 2017; 54:286-287. [PMID: 29103671 DOI: 10.1016/j.arbres.2017.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 08/13/2017] [Accepted: 08/15/2017] [Indexed: 01/01/2023]
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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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Skin Manifestations of Internal Disease in Older Adults. CURRENT GERIATRICS REPORTS 2015. [DOI: 10.1007/s13670-015-0135-8] [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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Lu YY, Liao JB, Wu CS, Hong CH. Pityriasis lichenoids chronica as a paraneoplastic dermatosis for primary splenic diffuse large B cell lymphoma. Indian J Hematol Blood Transfus 2014; 30:246-9. [PMID: 25332590 DOI: 10.1007/s12288-014-0344-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 01/15/2014] [Indexed: 11/29/2022] Open
Abstract
Paraneoplastic dermatosis is defined as both benign skin lesions and internal malignancy existing at the same time with parallel clinical courses. Herein, we report a 91-year-old male who presented as pityriasis lichenoids chronica (PLC) concomitantly with a primary splenic diffuse large B cell lymphoma. Surgical removal of the spleen cleared his skin lesions dramatically. However, seven months later, the splenic lymphoma relapsed in concordance with the recurrence of the skin lesions of PLC. To our knowledge, he is the first case that PLC is the leading presentation and paraneoplastic manifestation of primary splenic large B-cell lymphoma.
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Affiliation(s)
- Ying-Yi Lu
- Department of Dermatology, Kaohsiung Veterans General Hospital, No. 386 Ta-Chung 1st Rd, Kaohsiung City, 81362 Taiwan
| | - Jia-Bin Liao
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chieh-Shan Wu
- Department of Dermatology, Kaohsiung Veterans General Hospital, No. 386 Ta-Chung 1st Rd, Kaohsiung City, 81362 Taiwan
| | - Chien-Hui Hong
- Department of Dermatology, Kaohsiung Veterans General Hospital, No. 386 Ta-Chung 1st Rd, Kaohsiung City, 81362 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Silva JAD, Mesquita KDC, Igreja ACDSM, Lucas ICRN, Freitas AF, Oliveira SMD, Costa IMC, Campbell IT. Paraneoplastic cutaneous manifestations: concepts and updates. An Bras Dermatol 2013; 88:9-22. [PMID: 23538999 PMCID: PMC3699944 DOI: 10.1590/s0365-05962013000100001] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 10/16/2012] [Indexed: 12/31/2022] Open
Abstract
The skin often signals systemic changes. Some neoplastic diseases that affect
internal organs may trigger several cutaneous manifestations. Although these
dermatoses are relatively unusual, the recognition of some typical paraneoplastic
dermatoses may lead to the early diagnosis of a neoplasm and determine a better
prognosis. In this review article, we discuss the paraneoplastic cutaneous
manifestations strongly associated with neoplasms, which include acanthosis nigricans
maligna, tripe palms, erythema gyratum repens, Bazex syndrome, acquired
hypertrichosis lanuginosa, necrolytic migratory erythema, Leser-Trélat sign and
paraneoplastic pemphigus. We also review the clinical manifestations of each
condition and include updated knowledge on disease pathogenesis.
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9
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Acanthosis nigricans associated with an adrenocortical tumor in a pediatric patient. Case Rep Endocrinol 2013; 2013:174593. [PMID: 23819073 PMCID: PMC3683467 DOI: 10.1155/2013/174593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 05/19/2013] [Indexed: 11/17/2022] Open
Abstract
Malignant acanthosis nigricans (AN) is a rare paraneoplastic syndrome seen primarily in adults with an underlying diagnosis of gastrointestinal adenocarcinoma. Malignant AN is characterized by hyperpigmentation and velvety hyperplasia of the epidermis. This condition is generally not associated with tumors in pediatric populations or in the adrenal gland. We present a case of malignant AN in a pediatric patient with a nonmalignant, functional adrenocortical tumor.
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Yuste-Chaves M, Unamuno-Pérez P. Alertas cutáneas en malignidades sistémicas (parte I). ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.ad.2012.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Yuste-Chaves M, Unamuno-Pérez P. Cutaneous alerts in systemic malignancy: part I. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:285-98. [PMID: 23578547 DOI: 10.1016/j.adengl.2012.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 03/13/2012] [Indexed: 12/16/2022] Open
Abstract
The aim of this review is to familiarize dermatologists and clinicians in general with cutaneous signs and symptoms that can help lead to an early diagnosis of an underlying malignancy. Because the skin is one of the most accessible organs, it should never be overlooked in systemic disease. Examination of the skin has the advantage of revealing important information about the patient's condition without requiring the use of invasive techniques. In the literature, most discussions of cutaneous manifestations of internal malignancy refer to classic paraneoplastic syndromes, but a wide variety of skin conditions, while not strictly paraneoplastic, can, in certain contexts, indicate the presence of malignancy or an increased risk of developing cancer later in life. In this review, various skin conditions that can signal malignancy or increased cancer risk are presented in randomly ordered groups based on clinical morphology. Conditions with multiple signs and symptoms have been classified on the basis of their most characteristic feature.
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Affiliation(s)
- M Yuste-Chaves
- Servicio de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain.
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Costa MC, Martinez NS, Belicha MG, Leal F. Acanthosis nigricans and "tripe palm" as paraneoplastic manifestations of metastatic tumor. An Bras Dermatol 2013; 87:498-500. [PMID: 22714777 DOI: 10.1590/s0365-05962012000300030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Accepted: 12/25/2011] [Indexed: 11/22/2022] Open
Abstract
Acanthosis nigricans is a common dermatosis and is most often associated with benign conditions, such as insulin resistance. It is rare as a paraneoplastic marker. As such, it is characterized by sudden onset and rapid dissemination of velvety and hyperchromic skin lesions. The term "tripe palm" refers to exaggeration of the palmar ridge pattern, which resembles the internal surface of the bovine intestinal tract. This is a paraneoplastic marker of high specificity, with 90% of the cases being associated with malignancy. We report the case of a patient with stage IV ovarian adenocarcinoma presenting acanthosis nigricans and tripe palm. Both findings are closely correlated to the neoplasm course.
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Singh GK, Sen D, Mulajker DS, Suresh MS. Acanthosis nigricans associated with transitional cell carcinoma of the urinary bladder. Indian J Dermatol 2012; 56:722-5. [PMID: 22345779 PMCID: PMC3276905 DOI: 10.4103/0019-5154.91837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
An elderly man from the region of Ladakh presented with recurrent episodes of lower respiratory tract infection, rapidly progressive Acanthosis nigricans, Acanthosis palmaris and plantar keratoderma. Detailed investigations revealed underlying metastatic transitional cell carcinoma of the bladder. This case is being reported for its rarity in the literature.
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Affiliation(s)
- Gautam K Singh
- Department of Dermatology, Graded Specialist (Derm & Ven), Command Hospital Eastern Command, Kolkata, India
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Affiliation(s)
- Marcia Ramos-E-Silva
- Sector of Dermatology and Post Graduation Course of Dermatology, University Hospital Clementino Fraga Filho andSchool of Medicine, Federal University of Rio de Janeiro, 22280-020 Rio de Janeiro, Brazil.
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Ortega-Loayza AG, Ramos W, Gutierrez EL, Paz PCD, Bobbio L, Galarza C. Cutaneous manifestations of internal malignancies in a tertiary health care hospital of a developing country. An Bras Dermatol 2010; 85:736-42. [DOI: 10.1590/s0365-05962010000500026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Indexed: 11/22/2022] Open
Abstract
In a public hospital in Lima, Peru, 24 patients with 16 types of paraneoplastic dermatoses were identified by data collection. The most frequent dermatosis was dermatomyositis (four patients). The other dermatoses were malignant acanthosis nigricans, palmoplantar keratoderma, bullous dermatoses, lymphomatoid papulosis, edematous scarring vasculitic panniculitis, Norwegian scabies, primary systemic amyloidosis, necrolytic migratory erythema, infective dermatitis, pancreatic panniculitis, generalized pruritus, Lesser-Trelat syndrome, and acquired ichthyosis. Most of these paraneoplastic dermatoses were diagnosed before (45.8%) or at the time of (38.5%) the diagnosis of the underlying malignancy. The most frequent underlying malignancies were lymphoma, adenocarcinomas of the upper digestive tract, and malignant neoplasms of the pancreas. The average age of the patients was 47.0 ± 16.9 years and the length of the disease since diagnosis was 13.7 months. The mortality rate was 75%. Paraneoplastic dermatoses are rare dermatologic entities that are difficult to diagnose. Surveillance is also hampered when patients do not have easy access to health care centers due to financial and geographical issues. However, when identified, they might facilitate the early diagnosis of an associated tumor and contribute to increase the surveillance of patients.
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Acanthosis nigricans in a patient with lung cancer: a case report. Case Rep Med 2010; 2010. [PMID: 20811563 PMCID: PMC2929622 DOI: 10.1155/2010/412159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Accepted: 06/30/2010] [Indexed: 11/17/2022] Open
Abstract
Some skin lesions may accompany malignancies. Acanthosis nigricans, one such lesion, is a paraneoplastic dermatosis characterized by hyperpigmented and velvety verrucose plaques observed as symetric eruptions. With this report, we aim to present a rare case of concomitant lung cancer and acanthosis nigricans. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. A 65-year-old patient who had hyperpigmented, hypertrophic and symmetric verrucose lesions at the flexor surfaces of the lower and upper extremities, face, palms and the axillary region. Thoracic computed tomography demonstrated a hypodense mass lesion with a dimension of 5 × 5.5 cm at the center of basal segment bronchi of the left pulmonary lobe. Fiberoptic bronchoscopy showed that the access to the lower left lobe was almost completely obstructed by the endobronchial lesion. The result of the histopathologic examination of the endobronchial tissue biopsy was reported as non-small cell (adenocarcinoma) lung cancer. Result of the histopathologic analysis of the punch biopsy of the skin lesions was reported as acanthosis nigricans .There are no pathognomonic dermatological findings for lung cancer. In conclusion, there are skin lesions that accompany lung cancer and we believe that these should be considered for differential diagnosis.
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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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Abstract
Cutaneous paraneoplastic syndromes are a group of noncancerous dermatoses associated with internal malignancy. Their recognition can facilitate detection and timely treatment of underlying cancer. More than 30 such disorders have been identified in the human scientific literature, whereas only a few are described in veterinary medicine. This may reflect a lower incidence in animals than in people or may be the result of failure to recognize an association between certain skin lesions and neoplasia. Establishing a relationship between a cutaneous disorder and neoplasia can be difficult unless the skin lesions are rare and almost always associated with a particular tumour type, as is the case for most recognized veterinary paraneoplastic dermatoses. Among these are feline paraneoplastic alopecia, feline thymoma-associated exfoliative dermatitis, nodular dermatofibrosis, feminization syndrome associated with testicular tumours, superficial necrolytic dermatitis and paraneoplastic pemphigus. The aetiology of most cutaneous paraneoplastic syndromes has remained elusive in both people and animals.
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Affiliation(s)
- Michelle M Turek
- School of Veterinary Medicine, Department of Surgical Sciences, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA.
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Busam KJ, Sachs DL, Coit DG, Halpern A, Hwu WJ. Eruptive melanotic macules and papules associated with adenocarcinoma. J Cutan Pathol 2003; 30:463-9. [PMID: 12859746 DOI: 10.1034/j.1600-0560.2003.00089.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Malignancies may be associated with paraneoplastic cutaneous manifestations, including pigmentary disorders. METHODS The clinical findings were reviewed. Skin and tumor tissue samples were examined by routine histology, immunohistochemistry, and in one case also by electron microscopy. RESULTS Two patients developed diffuse melanotic macules and papules associated with visceral adenocarcinoma. One patient was a 64-year-old man with advanced carcinoma of the distal esophagus. The other was a 62-year-old man with metastatic pulmonary adenocarcinoma. The detection of the primary tumor in both patients was preceded by the rapid onset of melanotic macules and papules in the anogenital region and in one patient also around both nipples. The pigmented lesions were histologically characterized by a lentiginous melanocytic proliferation of large and heavily pigmented melanocytes associated with hyperpigmentation of adjacent keratinocytes. Both patients had been misdiagnosed as having epidermotropic metastatic malignant melanoma. None of them had prior, concurrent, or subsequent cutaneous or extracutaneous invasive melanoma. Both patients died of metastatic adenocarcinoma. CONCLUSION Eruptive melanotic macules and papules represent an under-recognized paraneoplastic syndrome. The cases illustrate a diagnostic pitfall for clinicians and pathologists unaware of this phenomenon.
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Affiliation(s)
- Klaus J Busam
- Department of Pathology, Clinical Immunology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
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