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Al‐Zahawi S, Sadeghi Y, Azhari V, Mahmoudi H, Daneshpazhooh M. Bullous pemphigoid, malignant acanthosis nigricans, and erysipeloid carcinoma in a woman with gastric adenocarcinoma. Clin Case Rep 2024; 12:e8351. [PMID: 38173884 PMCID: PMC10761616 DOI: 10.1002/ccr3.8351] [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: 11/23/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
Key Clinical Message Bullous pemphigoid did not follow the course of Gastric Carcinoma relapse and remisson, unlike the malignant acanthosis nigricans which was in alignment with the paraneoplastic effect of the Gastric Carcinoma. Abstract Acanthosis nigricans (AN) is a dermatosis characterized by the presence of hyperpigmented, velvety cutaneous thickening in the flexural areas, posterior neck, and occasionally the extensor surfaces of hand, face, and oral mucosa. AN is commonly associated with insulin resistance, drugs, and rarely internal malignancy (malignant AN). Bullous pemphigoid (BP) is an autoimmune blistering disease characterized by tense blisters involving the skin of mainly elderly patients. The association of BP and malignancy is not well established and the co-existence of BP with AN has not been reported. Here we report a 58-year-old, event-free gastric adenocarcinoma with three types of skin findings with different pathogenesis- BP, malignant AN, and erysipelas-like metastasis.
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Affiliation(s)
- Saman Al‐Zahawi
- Department of DermatologyRazi HospitalTehran University of Medical Sciences (TUMS)TehranIran
| | - Yasaman Sadeghi
- Department of DermatologyRazi HospitalTehran University of Medical Sciences (TUMS)TehranIran
| | - Vahidesadat Azhari
- Department of DermatopathologyRazi HospitalTehran University of Medical Sciences (TUMS)TehranIran
| | - Hamidreza Mahmoudi
- Department of DermatologyRazi HospitalTehran University of Medical Sciences (TUMS)TehranIran
- Autoimmune Bullous Diseases Research CenterRazi HospitalTehran University of Medical SciencesTehranIran
| | - Maryam Daneshpazhooh
- Department of DermatologyRazi HospitalTehran University of Medical Sciences (TUMS)TehranIran
- Autoimmune Bullous Diseases Research CenterRazi HospitalTehran University of Medical SciencesTehranIran
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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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Xia JY, Aadam AA. Advances in screening and detection of gastric cancer. J Surg Oncol 2022; 125:1104-1109. [PMID: 35481909 PMCID: PMC9322671 DOI: 10.1002/jso.26844] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022]
Abstract
With an estimated one million new cases and 769 000 deaths in 2020, gastric cancer is the fifth most frequent cancer and fourth leading cause of cancer death globally. Incidence rates are highest in Asia and Eastern Europe. This manuscript will review the current modalities of diagnosis, staging, and screening of gastric cancer. We will also highlight development of novel diagnostics and advancements in endoscopic detection of early gastric cancer.
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Affiliation(s)
- Jonathan Y Xia
- Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - A Aziz Aadam
- Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Dermatomyositis and colorectal cancer: a systematic review. Ir J Med Sci 2017; 187:615-620. [PMID: 29168152 DOI: 10.1007/s11845-017-1716-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 11/10/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND Dermatomyositis (DM) is an idiopathic inflammatory myositis. The principal characteristics are cutaneous rash, muscle ache, and muscle weakness. In the past, associations have been established between DM and malignancy, including colorectal cancer. METHODS A systematic PubMed and Scopus search was conducted. RESULTS The median age of the patients was 65 years (range 40-82). The majority were female (17 out of 27, 63%). Adenocarcinoma was the most frequent histological type of colorectal neoplasm. DM manifested before the diagnosis of colorectal cancer in 21 out of 27 patients (77.8%). At the time of the first presentation, creatine kinase was at a median level of 514.5 U/L (range 50-11,744), and serum antibodies were present in 11 out of 27 patients (40.7%). Immediate improvement of DM symptoms after surgery occurred in 14 out of 26 patients (53.8%). Recurrence of cancer in the form of distal metastasis was present in 5 out of 26 patients (19.2%). Cancer recurrence occurred within a median of 7.9 months (range 2-21) after surgery. In 7 out of 26 patients (26.9%), DM symptoms recurred during the post-operative period. Death was reported in 23 out of 27 patients (85.2%). CONCLUSION It is of paramount importance to perform a systematic diagnostic workup for malignancy, always including colonoscopy, in DM patients, since there is a high incidence of cancer in DM patients. Surgical treatment of colorectal tumors should precede the treatment of DM, as DM will frequently regress after a successful resection of malignancy.
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Ribero S, Balagna E, Sportoletti Baduel E, Picciotto F, Sanlorenzo M, Fierro MT, Quaglino P, Macripo G. Efficacy of electrochemotherapy for eruptive legs keratoacanthomas. Dermatol Ther 2016; 29:345-348. [PMID: 27272980 DOI: 10.1111/dth.12374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Generalized eruptive keratoacanthoma, is considered a serious condition because the eruptions are diffuse, persistent, and recurrent. Constant pruritus, visceral neoplasms, and unsatisfactory response to treatment are ominous prognostic factors. Even if skin cancers are usually well controlled with surgical and/or radiotherapic approaches, there are some cases in which these two techniques are not effective. With respect to surgery, radiotherapy and other standard treatments, ECT acts rapidly on multiple lesions with limited side effects and no functional impairment; moreover, repeated sessions can be performed to achieve or maintain the clinical response. We report a case of generalized eruptive keratoacanthomas in which electrochemotherapy was effective in inducing local regression of skin lesions. A 72-year-old woman with eruptive and painful keratoacanthomas for 3 months on both the lower limbs in which the conventional treatments could not be cosmetically acceptable. One session of electrochemotherapy with bleomycin sulfate was then performed on all isolated skin lesions. The treatment was well tolerated and led to a rapid clinical regression of the treated lesions. Use of ECT should be considered as an excellent alternative to current therapies in treatment of painful eruptive keratoacanthomas with a significant improvement of quality of life.
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Affiliation(s)
- S Ribero
- Department of Dermatologic Surgery, AOU Citta' della Salute e della Scienza di Torino, Turin, Italy. .,Department of Medical Sciences, University of Turin, Turin, Italy.
| | - E Balagna
- Department of Dermatologic Surgery, AOU Citta' della Salute e della Scienza di Torino, Turin, Italy
| | - E Sportoletti Baduel
- Department of Dermatologic Surgery, AOU Citta' della Salute e della Scienza di Torino, Turin, Italy
| | - F Picciotto
- Department of Dermatologic Surgery, AOU Citta' della Salute e della Scienza di Torino, Turin, Italy
| | - M Sanlorenzo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - M T Fierro
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - P Quaglino
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Macripo
- Department of Dermatologic Surgery, AOU Citta' della Salute e della Scienza di Torino, Turin, Italy
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Affiliation(s)
- Katrina Chakradeo
- Department of General Medicine, Mackay Hospital and Health Service, Mackay, Queensland, Australia
| | - Kaustubh Narsinghpura
- Department of Radiology, Mackay Hospital and Health Service, Mackay, Queensland, Australia
| | - Adel Ekladious
- Department of General Medicine, Mackay Hospital and Health Service, Mackay, Queensland, Australia
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Hemminki K, Sundquist K, Sundquist J, Ji J. Risk of cancer of unknown primary after hospitalization for autoimmune diseases. Int J Cancer 2015; 137:2885-95. [DOI: 10.1002/ijc.29657] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/03/2015] [Accepted: 06/10/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Kari Hemminki
- Department of Clinical Science in Malmö, Center for Primary Health Care Research; Lund University; Sweden
- Division of Molecular Genetic Epidemiology; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Kristina Sundquist
- Department of Clinical Science in Malmö, Center for Primary Health Care Research; Lund University; Sweden
- Department of Medicine, Stanford Prevention Research Center; Stanford University School of Medicine; Stanford CA
| | - Jan Sundquist
- Department of Clinical Science in Malmö, Center for Primary Health Care Research; Lund University; Sweden
- Department of Medicine, Stanford Prevention Research Center; Stanford University School of Medicine; Stanford CA
| | - Jianguang Ji
- Department of Clinical Science in Malmö, Center for Primary Health Care Research; Lund University; Sweden
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Gastric Cancer and Paraneoplastic Pemphigus. Indian J Surg 2015; 77:545-6. [PMID: 26884668 DOI: 10.1007/s12262-015-1311-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 06/19/2015] [Indexed: 10/23/2022] Open
Abstract
Paraneoplastic pemphigus is a relatively rare but significant acquired autoimmune mucocutaneous disorder that is characterised by diffuse erythema, painful blistering and sores of the skin and mucus membranes. The underlying pathogenesis is believed to be triggered by altered immune system in response to underlying neoplasm. The manifestations can predate, occur at the same time or after the diagnosis of cancer. Associations with gastric cancer have only been reported twice. A 78-year-old lady presented with a month's history of extensive skin lesions that started off as bullous lesions and biopsy revealed bullous pemphigus. Endoscopy for anemia revealed gastric cancer. This case reinforced the need to consider underlying malignancy in elderly patient with new onset dermatological presentation.
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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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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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Shah KR, Boland CR, Patel M, Thrash B, Menter A. Cutaneous manifestations of gastrointestinal disease. J Am Acad Dermatol 2013; 68:189.e1-21; quiz 210. [DOI: 10.1016/j.jaad.2012.10.037] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 10/11/2012] [Accepted: 10/13/2012] [Indexed: 01/13/2023]
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