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Katakura T, Shirai T, Sato H, Ishii T, Fujii H. Successful management of interstitial lung disease in dermatomyositis complicated by malignancy: a case-based review. Rheumatol Int 2024; 44:1781-1788. [PMID: 37682289 DOI: 10.1007/s00296-023-05442-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
Dermatomyositis (DM) is associated with interstitial lung disease (ILD) and malignancy. However, the coexistence of ILD and malignancy (DM-ILD-malignancy) is rare, and limited information exists regarding its management. Herein, we report the case of a 70-year-old man who developed DM with rapidly progressive ILD and advanced gastric cancer and provide a literature review of managing DM-ILD-malignancy. The patient presented with typical DM skin rashes and shortness of breath, which worsened within 1 month, without muscular symptoms. Additionally, the patient tested negative for myositis-specific autoantibodies (MSAs). Computed tomography revealed ILD and advanced gastric cancer, which was confirmed on endoscopic examination to be a poorly differentiated adenocarcinoma. Although the patient's ILD progressed rapidly, surgical treatment of the cancer was prioritized. Prednisolone (PSL) 0.5 mg/kg was initiated 3 days before surgery and increased to 1 mg/kg at 7 days postoperative. Remarkable improvement in the skin rash and ILD was observed, and the PSL dose was tapered without immunosuppressants. A literature review revealed that anti-melanoma differentiation-associated gene 5 and anti-aminoacyl transfer RNA synthetase antibodies are the predominant MSAs in DM-ILD-malignancy, and the optimal treatment should be determined based on several factors, including ILD patterns, and malignancy type and stage. In particular, lung cancer may be a risk factor for the acute exacerbation of ILD, and preceding immunosuppression would be useful. Furthermore, prioritizing surgery for gastric cancer is effective because of its paraneoplastic nature.
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Affiliation(s)
- Tokio Katakura
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tsuyoshi Shirai
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Hiroko Sato
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomonori Ishii
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Hiroshi Fujii
- Department of Rheumatology, Tohoku University Hospital Sendai, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
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2
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Masson AD, Ram-Wolff C, Bouaziz JD, Cayuela JM, Lorillon G, Frumholtz L, Cassius C, Petit A, Léonard-Louis S, Battistella M, Vignon-Pennamen MD, Rivet J, Meignin V, Duverger L, Jachiet M, Bagot M, Lazaridou I. Dermatomyositis versus mycosis fungoides: Challenges in the diagnosis of erythroderma with associated myositis. Ann Dermatol Venereol 2023; 150:129-133. [PMID: 36682974 DOI: 10.1016/j.annder.2021.04.011] [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] [Received: 09/08/2020] [Revised: 03/21/2021] [Accepted: 04/12/2021] [Indexed: 01/22/2023]
Affiliation(s)
- A de Masson
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France; Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - C Ram-Wolff
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - J D Bouaziz
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France; Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - J M Cayuela
- Laboratory of Hematology, University Hospital Saint-Louis AP-HP and EA3518 Université de Paris, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - G Lorillon
- Department of Pulmonology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - L Frumholtz
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - C Cassius
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France; Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - A Petit
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - S Léonard-Louis
- Department of Neuropathology, AP-HP, Pitié Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - M Battistella
- Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France; Department of Pathology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - M D Vignon-Pennamen
- Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France; Department of Pathology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - J Rivet
- Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France; Department of Pathology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - V Meignin
- Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France; Department of Pathology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - L Duverger
- Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France; Department of Pathology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - M Jachiet
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
| | - M Bagot
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France; Université de Paris, INSERM U976, 1 Avenue Claude Vellefaux, 75010 Paris, France.
| | - I Lazaridou
- Department of Dermatology, AP-HP, Saint-Louis Hospital, 1, avenue Claude Vellefaux, 75010 Paris, France
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Sun XF, Gao XD, Shen KT. Treatment of gastric cancer with dermatomyositis as the initial symptom: Two case reports and review of literature. World J Clin Cases 2022; 10:9727-9733. [PMID: 36186186 PMCID: PMC9516899 DOI: 10.12998/wjcc.v10.i27.9727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/24/2022] [Accepted: 08/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dermatomyositis (DM) is a rare autoimmune disease involving the connective tissue. The association between DM and gastric cancer remains unclear. Patients with DM have an increased risk of cancer and higher mortality. It requires immunosuppressive therapy, heightened surveillance, and immunologic response to internal malignancy.
CASE SUMMARY Two cases of gastric cancer with DM as the first symptom in Zhongshan Hospital, Fudan University (Shanghai, China) were reported. Two patients had a typical skin rash. The rash in the first patient involved mainly bilateral upper limbs and neck, while the second patient manifested rash associated mainly with the face, neck, and back. Both manifested muscle weakness in the extremities and elevated serum creatine kinase. Radical resection of the tumor dramatically improved DM-related symptoms in the two patients. The literature review showed that gastric cancer is more commonly associated with DM in middle-aged and older male populations.
CONCLUSION The findings suggest the need for comprehensive screening for malignant tumors in patients with DM refractory to long-term pharmacotherapy or hormone manipulation.
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Affiliation(s)
- Xiang-Fei Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai 200032, China
| | - Xiao-Dong Gao
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai 200032, China
| | - Kun-Tang Shen
- Department of General Surgery, Zhongshan Hospital, Fudan University School of Medicine, Shanghai 200032, China
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4
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Castillo RL, Femia AN. Covert clues: the non-hallmark cutaneous manifestations of dermatomyositis. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:436. [PMID: 33842657 PMCID: PMC8033358 DOI: 10.21037/atm-20-5252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Dermatomyositis (DM) is a strikingly heterogenous disease characterized by a broad and ever-evolving spectrum of cutaneous manifestations that transcend the classic “hallmarks” defined by Peter and Bohan in 1975. Despite the increasing preponderance and ubiquity of autoantibody, radiologic, and electrophysiologic testing, the diagnosis of DM still hinges largely on prompt detection of cutaneous manifestations of this condition. While pathognomonic cutaneous features of DM are more readily recognizable, many patients present with subtle and/or atypical skin manifestations, and diagnosis of DM may require clinician identification of these cutaneous clues. In this review, we highlight several of the lesser-known skin manifestations of DM, specifically, panniculitis, diffuse subcutaneous edema, erythroderma, calcinosis, ulceration, flagellate erythema, Wong-type DM, gingival telangiectasias, and the ovoid palatal patch. We describe the clinical and histopathologic presentation of these cutaneous findings. While manifesting less frequently than the heliotrope rash, Gottron’s papules, and Gottron’s sign, these cutaneous clues are equally important for clinicians to recognize in order to facilitate timely diagnosis and early intervention.
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Affiliation(s)
- Rochelle L Castillo
- Department of Medicine, Division of Rheumatology, NYU Grossman School of Medicine, New York, NY, USA
| | - Alisa N Femia
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, USA
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5
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Plachouri K, Georgiou S. Paraneoplastic erythroderma: an insight on the existing data. Int J Dermatol 2020; 59:1429-1436. [DOI: 10.1111/ijd.14970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/17/2020] [Accepted: 05/04/2020] [Indexed: 11/29/2022]
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6
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Miyashiro D, Arnone M, Ferreira PS, Romiti R, Sanches JA. Extensive cutaneous involvement by dermatomyositis: Report of six cases and review of the literature. Clin Exp Rheumatol 2020; 19:102680. [PMID: 33131689 DOI: 10.1016/j.autrev.2020.102680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Denis Miyashiro
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
| | - Marcelo Arnone
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Paula Silva Ferreira
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Ricardo Romiti
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - José Antonio Sanches
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
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Ali AA, Basharat P, Lovegrove F. A dermatomyositis/lichen planus overlap syndrome presenting with erythroderma: A case report. SAGE Open Med Case Rep 2019; 7:2050313X19845174. [PMID: 31080596 PMCID: PMC6498764 DOI: 10.1177/2050313x19845174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This case report describes a novel presentation of a lichen planus and dermatomyositis overlap syndrome. The patient presented with pruritic and painful violaceous erythroderma with biopsy reports suggestive of both lichen planus and dermatomyositis. The patient failed first-line treatment with prednisone and hydroxychloroquine and eventually required treatment with methotrexate and intravenous immunoglobulin to achieve control of her disease. Overlap syndromes have been described between lichen planus and lupus erythematosus; however, to date, little has been described about a dermatomyositis/lichen planus overlap.
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Affiliation(s)
- Asma Amir Ali
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Pari Basharat
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Fiona Lovegrove
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,Lovegrove Dermatology, London, ON, Canada
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8
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Wang L, Guo T, Zhang H, Li W, Zhu Y, Guo H, Yang F, Guo Y, Zhang Z, Han Y, Zhong D, Li X, Huang L. Rare paraneoplastic erythroderma associated with ectopic neuron-specific enolase deposition in basal cells. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:51. [PMID: 30906755 DOI: 10.21037/atm.2018.12.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The cutaneous symptom of the paraneoplastic erythroderma can be the only symptom of a malignancy. Although many cases associated with malignancies have been reported, the pathogenesis of cancer related erythroderma is still unclear. Herein we presented a patient with large cell neuroendocrine carcinoma (LCNEC) of the lung and contemporary severe erythroderma. The patient suffered from skin erythema and scaling all over the body and the cutaneous lesions recovered completely after 3 weeks of surgery. Strong expression of neuron-specific enolase (NSE, 2+ positive) was found in both primary cancer and basal cells of the preoperative skin. Three months later, postoperative skin biopsy presented nearly normal skin tissues, accompanied with a negative expression of NSE. Nine months after surgery, cancer recurred in the liver and brain with the first symptom of skin erythema and scaling. The pathology of liver biopsy tissues illustrated the LCNEC and 3+ positive expression of NSE. The skin biopsy tissues showed 2+ positive stain of NSE. Evaluation after two cycles of chemotherapy showed marked improvement in erythroderma and reduction of tumor volume. However, the patient experienced recurrent worsening of erythroderma when chemotherapy was terminated due to severe myelosuppression. Eleven months after surgery, the patient died of cancer cachexia and multiple organ failure. To our knowledge, this was the first case of paraneoplastic erythroderma associated with LCNEC of lung. Furthermore, we firstly discovered that the deposition of NSE in basal cells might be a crucial pathogenic factor of erythroderma.
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Affiliation(s)
- Lei Wang
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Ting Guo
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China.,Department of Pain Management, The Affiliated Hospital of Northwest University (Xi'an No. 3 Hospital), Xi'an 710082, China
| | - Hao Zhang
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Weimiao Li
- Department of Surgical Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Yifang Zhu
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Haihua Guo
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Feng Yang
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Yitong Guo
- Department of Ultrasound Diagnosis, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Zhipei Zhang
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Yong Han
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Daixing Zhong
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
| | - Lijun Huang
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710038, China
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Cuellar-Barboza A, Ocampo-Candiani J, Herz-Ruelas M. Eritrodermia en el adulto: un enfoque práctico para el diagnóstico y tratamiento. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:777-790. [DOI: 10.1016/j.ad.2018.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/20/2018] [Accepted: 05/23/2018] [Indexed: 01/19/2023] Open
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10
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A Practical Approach to the Diagnosis and Treatment of Adult Erythroderma. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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11
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Herath HMMTB, Keragala BSDP, Pahalagamage SP, Janappriya GHCC, Kulatunga A, Gunasekera CN. Erythroderma and extensive poikiloderma - a rare initial presentation of dermatomyositis: a case report. J Med Case Rep 2018; 12:83. [PMID: 29571300 PMCID: PMC5866516 DOI: 10.1186/s13256-018-1618-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/28/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Dermatomyositis is a humoral-mediated inflammatory myopathy with symmetrical proximal muscle weakness and dermatological manifestations such as Gottron's papules, heliotrope rash, periungual abnormalities, and flagellate erythema. Erythroderma is a severe and potentially life-threatening dermatological condition with diffuse erythema and scaling involving more than 90% of the skin surface area. Poikiloderma vasculare atrophicans refers to mottled hyperpigmentation and hypopigmentation of the skin with in-between telangiectases and areas of atrophy and is considered a variant of mycosis fungoides. Poikilodermatomyositis is the term given to the condition with poikiloderma and inflammatory myopathy. Only a few cases are reported on erythroderma in dermatomyositis and poikilodermatomyositis. Erythrodermal pattern of dermatomyositis transforming into poikilodermatomyositis is a recognized rare manifestation of dermatomyositis and we could find only one case report in the literature. CASE PRESENTATION A 53-year-old Sri Lankan woman presented with intermittent fever of 5 months' duration with erythroderma. Later she developed progressive, symmetrical proximal muscle weakness. Following a short course of small dose steroids, erythroderma settled but changed to extensive poikiloderma involving more than 90% of her skin with her face being relatively spared. She had an early heliotrope rash, shawl sign, and Gottron papules. Electromyography and muscle biopsy were supportive of inflammatory myositis and skin biopsy showed evidence of dermatomyositis. Inflammatory markers and muscle enzymes were also elevated. Autoimmune antibodies and myositis-specific autoantibodies were negative. She was started on orally administered prednisolone 1 mg/kg per day with methotrexate 10 mg once a week and had a good response to treatment with resolution of the skin condition and improvement of muscle power. Imaging studies, endoscopies, and tumor markers did not reveal any malignancy. CONCLUSIONS This case illustrates a rare presentation of dermatomyositis initially presenting as fever, erythroderma, and proximal muscle weakness and later developing poikiloderma involving more than 90% of the skin. It is important to be aware of this rare presentation to avoid misdiagnosis. With the currently available literature it is not possible to conclude that erythroderma is a bad prognostic factor in dermatomyositis or a predictive factor for a malignancy. Patients have a good response to steroids with a combination of immunosuppressants.
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12
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Hejna M, Wöll E, Tschandl P, Raderer M. Cutaneous paraneoplastic disorders in stomach cancer: Collaboration between oncologically active dermatologists and clinical oncologists. Crit Rev Oncol Hematol 2016; 103:78-85. [PMID: 27247117 DOI: 10.1016/j.critrevonc.2016.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 03/14/2016] [Accepted: 04/26/2016] [Indexed: 01/25/2023] Open
Abstract
To our knowledge this is the first systemic review that provides an overview of the cutaneous paraneoplastic syndromes (CPS) (i.e., clinical manifestations, pathomechanisms, and treatment modalities) occurring in stomach cancer. CPS are caused by substances produced by stomach cancer and may precede, coincide with, or follow the diagnosis of this malignancy. More than 20 possible CPS in association with stomach cancer have been identified. CPS mostly compromises the patient's quality of life by skin impairment plus discomfort and are often associated with a dismal prognosis on survival. Studies of these CPS not only in stomach cancer have partially contributed to the understanding of pathomechanism and since CPS may be the presenting sign of an occult cancer, cognizance of their features and clinical implications are of considerable importance. Patients with these syndromes should have an appropriate work-up for a possibly occult malignancy with consecutive successful early treatment.
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Affiliation(s)
- Michael Hejna
- Comprehensive Cancer Center-GET, Medical University of Vienna, Vienna, Austria.
| | - Ewald Wöll
- St.Vinzenz Krankenhaus Betriebs GmbH, Zams, Austria
| | - Philipp Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Markus Raderer
- Department of Internal Medicine I, Division of Oncology Medical University of Vienna, Vienna, Austria
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Ge W, Teng BW, Yu DC, Chen G, Zheng LM, Ding YT. Dermatosis as the initial presentation of gastric cancer: two cases. Chin J Cancer Res 2014; 26:632-8. [PMID: 25400431 DOI: 10.3978/j.issn.1000-9604.2014.10.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 08/15/2014] [Indexed: 01/01/2023] Open
Abstract
Paraneoplastic dermatoses are known to be certain dermatosis related with tumor. The common paraneoplastic dermatoses are acanthosis nigricans, acquired ichthyosis, dermatomyositis, erythroderma, and so on. Here we report two cases of paraneoplastic dermatoses associated with gastric cancer. One case was a 57-year-old man with dermatomyositis and proved to be associated with gastric cancer through stomachoscopy. The other was a 66-year-old man with erythroderma and proved to be associated with gastric cancer through stomachoscopy. Both cases were treated with radical total gastrectomy with lymphadenectomy (D2) and esophagojejunostomy of Roux-en-Y. The skin symptom of both cases had improved a lot but still existed after operation. Paraneoplastic dermatoses can be seen as the early manifestation of visceral carcinomas. As a result, gastric cancers should be excluded in the patients with paraneoplastic dermatoses.
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Affiliation(s)
- Wei Ge
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Bu-Wei Teng
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - De-Cai Yu
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Gang Chen
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Li-Ming Zheng
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Yi-Tao Ding
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
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14
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Dermatomyositis-erythrodermia: clinical presentation not associated to malignancy. A case report. ACTA ACUST UNITED AC 2013; 10:48-50. [PMID: 23545145 DOI: 10.1016/j.reuma.2012.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 12/13/2012] [Accepted: 12/19/2012] [Indexed: 11/23/2022]
Abstract
The association of erythroderma and dermatomyositis is rare. In 6 reported cases found by searching Pubmed, half of them were associated with digestive tract neoplasms (stomach and liver). We report the case of a 69 years-old woman with bilateral proximal weakness, joint pain, photosensitivity, facial and heliotrope erythema lasting 18 months. One month prior to hospital admission she showed progressive dysphagia and a universal erythema and scaling that affected mucosa, palms and soles with an accompanying weight loss of 10 kg in 6 months. No malignancy was identified at any level despite an exhaustive search.
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