1
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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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2
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Mehta H, Sonagara B, Astik B, Agrawal N. Study of seborrheic keratosis by dermoscopy using polarized and nonpolarized modes. INDIAN JOURNAL OF DERMATOPATHOLOGY AND DIAGNOSTIC DERMATOLOGY 2020. [DOI: 10.4103/ijdpdd.ijdpdd_48_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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3
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Anwar A, Jafri F, Ashraf S, Jafri MAS, Fanucchi M. Paraneoplastic syndromes in lung cancer and their management. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:359. [PMID: 31516905 DOI: 10.21037/atm.2019.04.86] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Paraneoplastic syndromes are most frequently associated with lung cancer. This review considers a variety of paraneoplastic syndromes associated with lung cancer and discusses their pathophysiology, clinical features and management options.
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Affiliation(s)
- Asad Anwar
- Department of Internal Medicine, Westchester Medical Center, Valhalla, NY, USA
| | - Firas Jafri
- Department of Internal Medicine, Westchester Medical Center, Valhalla, NY, USA
| | - Sara Ashraf
- Department of Hematology/Oncology, Marshall University, Huntington, WV, USA
| | - Mohammad Ali S Jafri
- Department of Hematology/Oncology, Westchester Medical Center, Valhalla, NY, USA
| | - Michael Fanucchi
- Department of Hematology/Oncology, Westchester Medical Center, Valhalla, NY, USA
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4
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Karakas Y, Esin E, Lacin S, Ceyhan K, Heper AO, Yalcin S. A case of acanthosis nigricans as a paraneoplastic syndrome with squamous cell lung cancer. Onco Targets Ther 2016; 9:4815-20. [PMID: 27536145 PMCID: PMC4976921 DOI: 10.2147/ott.s95020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A 55-year-old man presented with oral mucosal ulcers, blackening of both hands, and hyperpigmentation on axillary, anal, and inguinal regions for the last 3 months, which were all progressive. The patient was referred to the oncology department with the diagnosis of acanthosis nigricans for investigation of an underlying malignancy. He was a smoker. A computed tomography scan of thorax revealed enlarged mediastinal lymphadenopathies and a lesion on the left upper lobe. Fine-needle aspiration biopsy of the mediastinal lesion was consistent with squamous cell carcinoma, and biopsies of the skin and oral mucosal lesion also further confirmed the diagnosis of acanthosis nigricans. After docetaxel and cisplatin chemotherapy, a significant improvement in his skin and mucosal lesions was observed with almost complete resolution of the pulmonary lesion and the mediastinal lymph nodes.
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Affiliation(s)
- Yusuf Karakas
- Medical Oncology Department, Hacettepe University Cancer Institute
| | - Ece Esin
- Medical Oncology Department, Hacettepe University Cancer Institute
| | - Sahin Lacin
- Medical Oncology Department, Hacettepe University Cancer Institute
| | - Koray Ceyhan
- Department of Medical Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Aylin Okcu Heper
- Department of Medical Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Suayib Yalcin
- Medical Oncology Department, Hacettepe University Cancer Institute
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5
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Pandya C, Blazey H, Budev MM, Mehta AC, Minai OA. Acanthosis Nigricans following Single Lung Transplantation: A Case Report. Prog Transplant 2016; 16:239-41. [PMID: 17007159 DOI: 10.1177/152692480601600309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Acanthosis nigricans was observed 3 months after single lung transplantation in a 51-year-old African American woman with idiopathic pulmonary fibrosis. The patient had no endocrinological abnormalities and was not taking any medications known to cause acanthosis nigricans; extensive investigation did not reveal an underlying malignant process. Because acanthosis nigricans may occur as a paraneoplastic phenomenon, it is important to rule out an underlying malignancy. This is especially important in solid-organ transplant recipients receiving chronic immunosuppressive therapy.
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Affiliation(s)
- Chirag Pandya
- Huron Hospital/Cleveland Clinic Health System, Cleveland, Ohio, USA
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6
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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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7
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Onajin O, Comfere NI. Co-occurrence of malignant acanthosis nigricans and the Leser-Trélat sign in a patient with hepatocellular carcinoma. Int J Dermatol 2014; 54:e146-8. [DOI: 10.1111/ijd.12096] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Oluwakemi Onajin
- Department of Dermatology; Laboratory Medicine and Pathology; Rochester MN USA
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8
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Singh SK, Rai T. A rare case of malignant acanthosis nigricans in a lady with ovarian cancer. Indian Dermatol Online J 2013; 4:125-7. [PMID: 23741672 PMCID: PMC3673379 DOI: 10.4103/2229-5178.110640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
“Tripe palms” or pachydermatoglyphy is a descriptive term of acanthosis nigricans of the palms and is associated with internal malignancy. It often precedes the diagnosis of a new or recurrent tumor. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. In patients with both tripe palms and acanthosis nigricans, gastric carcinoma is the most common followed by lung carcinoma. There are very few reports in the literature of malignant acanthosis nigricans associated with gynecological malignancies. We report this case because of its rarity. A 47-year-old lady presented with lower abdominal swelling and progressive hyperpigmentation which preceded the abdominal swelling by 6 months. On investigations, she was found to have ovarian cancer. The presence of acanthosis nigricans in conjunction with tripe palms in a female patient is highly suggestive of an internal malignancy including an ovarian cancer and demands an extensive search for the hidden ovarian cancer.
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Affiliation(s)
- Satyendra Kumar Singh
- Department of Dermatology and Venereology, Institute of Medical Sciences, B.H.U., Varanasi, India
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9
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Zhang N, Qian Y, Feng AP. Acanthosis nigricans, tripe palms, and sign of Leser-Trélat in a patient with gastric adenocarcinoma: case report and literature review in China. Int J Dermatol 2013; 54:338-42. [PMID: 23675743 DOI: 10.1111/ijd.12034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Na Zhang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 430022
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10
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Jakubovic BD, Sawires HF, Adam DN. Occult cause of paraneoplastic acanthosis nigricans in a patient with known breast dcis: case and review. ACTA ACUST UNITED AC 2012; 19:e299-302. [PMID: 22876161 DOI: 10.3747/co.19.997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Paraneoplastic acanthosis nigricans (pan) is an infrequently encountered cutaneous manifestation of internal malignancy. Here, we describe a case of pan in the setting of a known breast ductal carcinoma in situ, which, to our knowledge, had not been described in association with pan. As a result, thorough investigation was undertaken to search for another concurrent neoplasm that would better explain the development of pan. In so doing, we identified a coexisting metastatic cholangiocarcinoma. We thus conclude that when pan is observed in an uncommon association with a known malignancy, further investigation should be undertaken to explore whether a more likely occult culprit exists.
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Affiliation(s)
- B D Jakubovic
- Faculty of Medicine, University of Toronto, Toronto, ON
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11
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Abstract
Gastric adenocarcinoma is one of the most common causes of death worldwide. Surgical resection remains the mainstay of therapy, offering the only chance for complete cure. Resection is based on the principles of obtaining adequate margins, with the extent of lymphadenectomy remaining controversial. Neoadjuvant and adjuvant therapies are used to reduce local recurrence and improve long-term survival. This article reviews the literature and provides a summary of surgical management options and neoadjuvant/adjuvant therapies for gastric adenocarcinoma.
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Affiliation(s)
- Sameer H Patel
- Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, 1365C Clifton Road, Northeast 2nd Floor, Atlanta, GA 30322, USA
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12
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Chrysomali E, Piperi E, Sklavounou-Andrikopoulou A. Oral acanthosis nigricans in chronic hepatitis B with a 21-year follow up. J Dermatol 2011; 38:1172-6. [PMID: 21966946 DOI: 10.1111/j.1346-8138.2011.01252.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Acanthosis nigricans is a rare mucocutaneous disorder of unknown etiology that manifests as hyperpigmented velvety plaques, most often on intertriginous areas such as the neck and axillae as well as on mucosal sites such as the oral cavity. The disorder presents either as a paraneoplastic manifestation of an underlying malignancy, especially gastrointestinal adenocarcinomas or in association with obesity, administration of drugs or endocrinopathies, most commonly insulin-resistant diabetes mellitus. In the present article, a case of acanthosis nigricans with oral and cutaneous manifestations in a male patient with chronic hepatitis B infection is described. To the best of our knowledge, this is the first case of benign oral acanthosis nigricans associated with chronic hepatitis B.
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Affiliation(s)
- Evanthia Chrysomali
- Department of Oral Pathology and Medicine, Dental School, National and Kapodistrian University of Athens, Athens, Greece.
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13
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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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14
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Mukherjee S, Pandit S, Deb J, Dattachaudhuri A, Bhuniya S, Bhanja P. A case of squamous cell carcinoma of lung presenting with paraneoplastic type of acanthosis nigricans. Lung India 2011; 28:62-4. [PMID: 21654990 PMCID: PMC3099515 DOI: 10.4103/0970-2113.76305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A 70-years-old male presented with blackening of both hands and face for last six months which was progressive and attended dermatology outpatients department. Dermatologist opined the skin lesions as acanthosis nigricans. He was referred to our department to evaluate for any underlying internal malignancy as he was a smoker. His chest X-ray revealed right sided hilar prominence with a mid zone cavity with fluid level. Fibreoptic bronchoscopy was done, there was one ulcerative growth in right middle lobe bronchus. Biopsy from the ulcer revealed probable squamous cell carcinoma. CT scan of thorax was also done and CT guided FNAC of Rt lung lesion yielded non small cell carcinoma. His skin lesions were also biopsied and diagnosis of acanthosis nigricans was confirmed. Here we report a case of acanthosis nigricans associated with non-small cell cancer of lung.
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Affiliation(s)
- Subhasis Mukherjee
- Department of Respiratory Medicine, R.G. Kar Medical College and Hospital, Kolkata - 700 004, West Bengal, India
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15
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Tazi MF, Mellas S, Mellas N, Znati K, Tazi EM, Masbah O, Boubbou M, El Fassi MJ, Farih MH. Acanthosis nigricans, manifestation cutanée rare d’un carcinome urothélial de vessie: à propos d’un cas. ONCOLOGIE 2010. [DOI: 10.1007/s10269-009-1053-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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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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17
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Oh CW, Yoon J, Kim CY. Malignant Acanthosis Nigricans Associated with Ovarian Cancer. Case Rep Dermatol 2010; 2:103-109. [PMID: 20689633 PMCID: PMC2914370 DOI: 10.1159/000317116] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Malignant acanthosis nigricans is a cutaneous eruption characterized by symmetric hyperpigmented hyperkeratosis, dermal papillomatosis, and mucosal involvement associated with internal malignancies. Tripe palms refers to a characteristic velvety thickening of the palms, with exaggeration of normal skin markings. We present the second case of ovarian cancer in association with two coexisting paraneoplastic dermatoses occurring in a 57-year-old Korean female. The presence of acanthosis nigricans in conjunction with tripe palms in a female patient is highly suggestive of an internal malignancy including an ovarian cancer and demands an extensive search for the hidden ovarian cancer.
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Affiliation(s)
- Chee Won Oh
- Department of Dermatology, School of Medicine, Kangwon National University Hospital, Hyoja-dong, Chuncheon, Korea
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18
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Dourmishev LA, Draganov PV. Paraneoplastic dermatological manifestation of gastrointestinal malignancies. World J Gastroenterol 2009; 15:4372-9. [PMID: 19764087 PMCID: PMC2747056 DOI: 10.3748/wjg.15.4372] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Numerous dermatological disorders have been associated with underlining malignancies of the gastrointestinal (GI) tract. Such cutaneous manifestations might have an important diagnostic value if they are the sole expressions of otherwise asymptomatic carcinomas. The recognition of some typical paraneoplastic dermatologic disorders can lead to the prompt diagnosis of the underlying malignancy, timely administration of therapy, and ultimately, better prognosis. In this review we discuss the most common paraneoplastic dermatological syndromes from the perspective of the practicing gastroenterologist. We also outline a comprehensive practical approach for the evaluation for occult malignancy in patients presenting with cutaneous findings potentially associated with GI cancers.
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19
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Bilateral Leser-Trélat sign mirroring lung adenocarcinoma with early metastases to the contralateral lung. South Med J 2009; 102:216-8. [PMID: 19209445 DOI: 10.1097/smj.0b013e31818f604d] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a case featuring a unique overlap between the body areas involved by lung adenocarcinoma and the cutaneous paraneoplastic sign of Leser-Trélat. In our patient, the Leser-Trélat sign consisted of explosive multiple seborrheic keratoses in combination with acanthosis nigricans, representing a remarkable geometric skin projection of lung cancer which involved both the upper lobes. Our case suggests a unique interrelation between the paraneoplastic sign of Leser-Trélat and the tumor itself. The recognition of this phenomenon may contribute to an early diagnosis and prompt surgical treatment of occult cancers.
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20
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Scully C, Barrett W, Gilkes J, Rees M, Sarner M, Southcott R. Oral acanthosis nigricans, the sign of Leser-Trélat and cholangiocarcinoma. Br J Dermatol 2008. [DOI: 10.1111/j.1365-2133.2001.04393.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Background: The sudden appearance of acanthosis nigricans on
the skin of an individual is highly suggestive of an underlying
clinical disease. However, there is no information on its possible
association with head and neck disease in our environment. Objective:
To determine the prevalence of acanthosis nigricans
and identifying the underlying associated medical and oncologic
factor in an Otorhinolaryngologic, head and neck practice. Method:
This was a 12-month prospective study of patients seen
at Otorhinolaryngology department of University College
Hospital, Ibadan. Relevant clinical, anthropometric and
biochemical information were obtained with an interviewer assisted
questionnaire and data analyzed using descriptive statistics. Results:
Of 764 patients, 85(11.13%) had head and neck
malignancies, 15(1.96%) had diabetes mellitus in addition to the
Otorhinolaryngologic, head and neck diseases. The body mass
index values for male and female ranged from 18.26 – 25.68kg/m2 and 17.94 – 30.25kg/m2 respectively. Only two patients, one with
nasopharyngeal cancer and the other with obesity in addition to
chronic rhinosinusitis had acanthosis nigricans. Conclusion:
Acanthosis nigricans is not common among
Otorhinolaryngologic patients in our clinical setting with a
prevalence of 0.003. Nevertheless, its presence should herald the
suspicion of an underlying metabolic or oncologic disease.
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Affiliation(s)
- James A Fasunla
- Department of Otorhinolaryngology, University College Hospital, Ibadan
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23
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Hueso L, Requena C, Alfaro-Rubio A, Serra-Guillén C. Paraneoplastic Ichthyosis. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s1578-2190(08)70263-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Do JE, Kim YC. Capecitabine-induced diffuse palmoplantar keratoderma: is it a sequential event of hand-foot syndrome? Clin Exp Dermatol 2007; 32:519-21. [PMID: 17509060 DOI: 10.1111/j.1365-2230.2007.02451.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Capecitabine was developed as a prodrug of 5-fluorouracil (FU), with the goal of improving tolerability and intratumour drug concentrations through tumour-specific conversion to the active drug against numerous types of neoplasms. The most frequent adverse cutaneous reaction associated with capecitabine is hand foot syndrome (HFS), presented with symmetrical erythema, dysaesthesia, and desquamation on the palms and soles. Acquired palmoplantar keratoderma (PPK) can occur in various dermatoses associated with metabolic abnormalities, malignancies, and toxic agents. However, there has been no report of PPK after capecitabine chemotherapy. We report two cases of diffuse PPK, which developed in patients with metastatic breast cancer after one cycle of capecitabine chemotherapy. Because oral capecitabine is increasingly used for various solid tumours, clinicians should be aware that keratoderma can develop during capecitabine chemotherapy as a sequential event of HFS.
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Affiliation(s)
- J E Do
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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26
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Abstract
BACKGROUND Dermatology signs serve as important clues to primary skin disorders and internal conditions. OBJECTIVE AND METHODS To highlight major cutaneous signs based on a MEDLINE literature search from 1966 to March 2006. RESULTS AND CONCLUSIONS A multitude of signs exist in dermatology. Appreciation and knowledge of cutaneous signs will enhance the care of patients with dermatologic manifestations.
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Affiliation(s)
- Anatoli Freiman
- Division of Dermatology, University of Toronto, Toronto, ON, Canada.
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27
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Abstract
Dermatologic problems are common in diabetes, with approximately 30% of patients experiencing some cutaneous involvement during the course of their illness. Skin manifestations generally appear during the course of the disease in patients known to have diabetes, but they may also be the first presenting sign of diabetes or even precede the diagnosis by many years. The skin involvement can be autoimmune in nature, such as acanthosis nigricans, necrobiosis lipoidica, diabetic dermopathy, scleredema, and granuloma annulare, or infectious in the form of erythrasma, necrotizing fasciitis, and mucormycosis. Pharmacologic management of diabetes, in addition, can also result in skin changes, such as lipoatrophy and lipohypertrophy, at the site of injection of insulin, and oral antidiabetic agents can cause multiple skin reactions as adverse effects. The management of these cutaneous manifestations is tailored according to the underlying pathophysiology, but a tight control of blood glucose is a prerequisite in all management strategies.
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Affiliation(s)
- Intekhab Ahmed
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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28
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Pandya C, Blazey H, Budev M, Mehta A, Minai O. Acanthosis nigricans following single lung transplantation: a case report. Prog Transplant 2006. [DOI: 10.7182/prtr.16.3.n2rq238kq58g7472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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29
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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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30
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Pardo J, Iglesias R, Mercader P, Rodríguez-Serna M. [Diffuse darkening of the skin]. ACTAS DERMO-SIFILIOGRAFICAS 2006; 96:59-61. [PMID: 16476338 DOI: 10.1016/s0001-7310(05)73038-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- José Pardo
- Servicio de Dermatología, Consorcio Hospital General Universitario, Avda. Tres Cruces s/n, 46014 Valencia, Spain.
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Csete B, Moezzi M, Lengyel Z, Hodosi B, Zombai E, Battyáni Z. Florid cutaneous papillomatosis leading to social exclusion. Br J Dermatol 2005; 153:667-9. [PMID: 16120165 DOI: 10.1111/j.1365-2133.2005.06772.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kalt A, Wagner A, Zeuzem S, Tilgen W, Reichrath J. Generalisierte Hyperpigmentierung und Acanthosis nigricans maligna bei einem Patienten mit hereditärer Hämochromatose und Magenkarzinom. Hautarzt 2005; 56:581-5. [PMID: 15645193 DOI: 10.1007/s00105-004-0869-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A 56-year-old previously healthy man developed hyperpigmentation of the entire skin over the previous 6 months without any other signs of further impairment. Additionally, we found accentuated skin lines of the neck and intertriginous sites as well as cutaneous papillomatosis. Histological examinations, laboratory tests and technical diagnostics revealed the existence of both hereditary hemochromatosis and adenocarcinoma of the stomach. Simultaneous manifestation of hyperpigmentation as a result of hemochromatosis as well as malignant acanthosis nigricans as a paraneoplastic symptom in gastric cancer is very rare.
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Affiliation(s)
- A Kalt
- Klinik für Dermatologie Venerologie und Allergologie, Universitätsklinikum des Saarlandes Homburg/Saar.
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Ramirez CC, Berman B. Cutaneous signs and syndromes associated with internal malignancies. Skinmed 2005; 4:84-90; quiz 91-2. [PMID: 15785135 DOI: 10.1111/j.1540-9740.2005.03379.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cutaneous changes may indicate the presence of or herald the incipient development of internal malignancies. The authors review 24 cutaneous signs, symptoms, diseases, and syndromes associated with internal malignancies. Early recognition of these cutaneous changes may allow for vigilance for, and prompt detection and management of, the underlying neoplasm.
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Affiliation(s)
- Claudia C Ramirez
- Department of Dermatology and Cutaneous Surgery, University of Miami, Rosenstiel Medical Sciences Building, Room 2023 A (R250), 1600 Northwest 10th Avenue, Miami, FL 33136, USA
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34
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Master SS. Gastric carcinoma. Dis Mon 2004; 50:532-9. [PMID: 15616487 DOI: 10.1016/j.disamonth.2004.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Sonali S Master
- Section of Gastroenterology, Northwestern Memorial Hospital, Feinberg School of Medicine at Northwestern University, USA
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Pentenero M, Carrozzo M, Pagano M, Gandolfo S. Oral acanthosis nigricans, tripe palms and sign of leser-trélat in a patient with gastric adenocarcinoma. Int J Dermatol 2004; 43:530-2. [PMID: 15230897 DOI: 10.1111/j.1365-4632.2004.02159.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Acanthosis nigricans (AN), tripe palms (TP) and the sign of Leser-Trélat (LT) may be seen with the presence of malignancy. Acanthosis nigricans may have a mucocutaneous localization involving the oral mucosa with papillomatous and verrucous lesions usually on the lips and buccal mucosa. These paraneoplastic dermatoses are generally linked with intra-abdominal malignancy, most often gastric adenocarcinoma. Improvement of the associated dermatoses after the treatment of the malignancy has been frequently observed. We report the case of a 53-year-old man suffering from advanced gastric adenocarcinoma, in which metastases seemed to sustain all three paraneoplastic dermatoses. To the best of our knowledge this is the first case of a patient showing manifestations of all three paraneoplastic dermatoses. Patients presenting with this set of dermatoses should be suspected to harbor an occult malignancy, or have persistence of a known malignancy.
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Affiliation(s)
- M Pentenero
- Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, and Surgical Pathology Section, University of Turin, Turin, Italy
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Blázquez N, Fernández-López E, Fernández-Canedo I, Unamuno PD, Martín-Pascual A. Signo de Leser-Trélat asociado a síndrome de Sézary. ACTAS DERMO-SIFILIOGRAFICAS 2003. [DOI: 10.1016/s0001-7310(03)76692-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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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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Scully C, Barrett WA, Gilkes J, Rees M, Sarner M, Southcott RJ. Oral acanthosis nigricans, the sign of Leser-Trélat and cholangiocarcinoma. Br J Dermatol 2001; 145:506-7. [PMID: 11531848 DOI: 10.1046/j.1365-2133.2001.04393.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Inuzuka M, Tomita K, Tokura Y, Takigawa M. Acquired ichthyosis associated with dermatomyositis in a patient with hepatocellular carcinoma. Br J Dermatol 2001; 144:416-7. [PMID: 11251586 DOI: 10.1046/j.1365-2133.2001.04040.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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