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May Lee M, Naldi L, Pierobon E, Leuzzi M, Sechi A. Florid cutaneous papillomatosis and acanthosis nigricans as cutaneous findings in a patient with ovarian carcinoma. J Cosmet Dermatol 2023. [PMID: 36892107 DOI: 10.1111/jocd.15699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/05/2023] [Accepted: 02/16/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Marco May Lee
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Luigi Naldi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Elena Pierobon
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Miriam Leuzzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Andrea Sechi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
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2
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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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3
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Abstract
The skin is often the herald of an underlying systemic illness, and gastrointestinal malignancies can present in numerous ways in the skin. Paraneoplastic phenomenon, such as acanthosis nigricans and tripe palm, may be the first indicator of a gastrointestinal malignancy. In addition, gastrointestinal cancers can metastasize to the skin, as described in the well-known Sister Mary Joseph's nodule. Inflammatory systemic conditions such as dermatomyositis and multicentric reticulohistiocytosis can be associated with underlying malignancy. Finally, in numerous genetic syndromes with underlying malignancies, such as Muir-Torre, recognition of the skin signs leads to early diagnosis and screening.
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4
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Malignant acanthosis nigricans, florid cutaneous papillomatosis and tripe palms syndrome associated with gastric adenocarcinoma. Postepy Dermatol Alergol 2014; 31:56-8. [PMID: 24683401 PMCID: PMC3952059 DOI: 10.5114/pdia.2014.40663] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/23/2013] [Accepted: 09/18/2013] [Indexed: 01/14/2023] Open
Abstract
Malignant acanthosis nigricans is a rare paraneoplastic skin syndrome mostly associated with gastric adenocarcinoma. Florid cutaneous papillomatosis and tripe palms syndrome are considered to be abortive clinical variants of acanthosis nigricans. Clinical manifestations include pruritic, hyperkeratotic and hyperpigmented plaques with a subsequent formation of velvety papillomas in the involved areas. This case report describes an unusual case of the patient diagnosed with a combination of malignant acanthosis nigricans, florid cutaneous papillomatosis and tripe palms syndrome associated with gastric adenocarcinoma.
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5
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Klieb HB, Avon SL, Gilbert J, Sade S, Enepekides D. Florid Cutaneous and Mucosal Papillomatosis: Mucocutaneous Markers of an Underlying Gastric Malignancy. J Clin Oncol 2013; 31:e218-9. [DOI: 10.1200/jco.2012.45.2151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hagen B.E. Klieb
- University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Canada
| | | | - Jeremy Gilbert
- University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sachar Sade
- University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Danny Enepekides
- University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Canada
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6
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Schulmann K, Strate K, Pox CP, Wieland U, Kreuter A. Paraneoplastic Acanthosis Nigricans With Cutaneous and Mucosal Papillomatosis Preceding Recurrence of a Gastric Adenocarcinoma. J Clin Oncol 2012; 30:e325-6. [DOI: 10.1200/jco.2012.42.5454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Katharina Strate
- Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Christian P. Pox
- Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
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7
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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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8
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Abu-Safieh Y, Khelfa S. Acanthosis nigricans: A presentation of gastric adenocarcinoma. Arab J Gastroenterol 2011; 12:156-7. [PMID: 22055596 DOI: 10.1016/j.ajg.2011.04.001] [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: 10/31/2010] [Accepted: 04/01/2011] [Indexed: 11/27/2022]
Affiliation(s)
- Yasser Abu-Safieh
- Specialised Arab Hospital, Annajah University, Nablus, Occupied Palestinian Territory.
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9
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Brinca A, Cardoso JC, Brites MM, Tellechea Ó, Figueiredo A. Papilomatose cutânea florida e acantose nigricante maligna reveladoras de neoplasia gástrica. An Bras Dermatol 2011; 86:573-7. [DOI: 10.1590/s0365-05962011000300025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Accepted: 06/20/2010] [Indexed: 11/21/2022] Open
Abstract
Apresenta-se o caso clínico de um doente de 57 anos, previamente saudável, sem sintomatologia sistêmica, que, num curto intervalo de tempo, desenvolve múltiplas lesões semelhantes a verrugas virais no tronco, membros e face, lesões típicas de acantose nigricante nas grandes pregas e uma queratodermia difusa palmar com paquidermatoglifia. Os exames complementares de diagnóstico revelaram uma neoplasia gástrica metastizada. Apesar da instituição da terapêutica, com efeito transitório na neoplasia e nas lesões cutâneas, o doente viria a falecer em 14 meses. Salientamos a associação destas três dermatoses paraneoplásicas num mesmo paciente: papilomatose cutânea florida, acantose nigricante maligna e tripe palms que parecem ter um mecanismo patogênico comum
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11
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Yoo KH, Rho YK, Kim JY, Li K, Seo SJ, Hong CK. Cutaneous Paraneoplastic Syndrome in a Patient With Adenocarcinoma of Unknown Primary Site Syndrome. J Clin Oncol 2009; 27:309-11. [DOI: 10.1200/jco.2008.19.6758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kwang Ho Yoo
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Yong Kwan Rho
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Ji Young Kim
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Kapsok Li
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Seong Jun Seo
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Chang Kwun Hong
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
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12
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Woo VL, Abdelsayed R. Oral manifestations of internal malignancy and paraneoplastic syndromes. Dent Clin North Am 2008; 52:203-x. [PMID: 18154871 DOI: 10.1016/j.cden.2007.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Malignant tumors of visceral organs are a fundamental feature of familial cancer and paraneoplastic syndromes. In many instances, the presence of an internal and often occult malignancy may be forewarned by various external manifestations. Several of these findings are preferentially localized to the head and neck region, including the oral cavity proper. This places the dental practitioner in a unique position to detect these "markers" of occult neoplastic involvement. Because these markers may present before an established syndrome or cancer diagnosis, even representing the first expression of disease in some cases, early recognition by a dentist may lead to timely diagnosis and management of these cancer-associated syndromes.
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Affiliation(s)
- Victoria L Woo
- Columbia University College of Dental Medicine, 630 West 168th Street, PH 1562 West, New York, NY 10032, USA.
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13
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Florid cutaneous papillomatosis with acanthosis nigricans in a patient with carcinomas of the lung and prostate. J Am Acad Dermatol 2007; 57:907-8. [PMID: 17939948 DOI: 10.1016/j.jaad.2006.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2005] [Revised: 02/02/2006] [Accepted: 02/06/2006] [Indexed: 11/23/2022]
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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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15
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Abstract
A male patient aged 74, an inpatient at the chest diseases clinic at Ege University Hospital, Izmir, Turkey with squamous cell carcinoma in the right lung, was referred for consultation to the dermatology outpatient clinic as he presented with itchy papules recently increasing in number and a lesion on his nose with a duration of 2 years. In a lung X-ray taken to investigate hemoptisis, a mass 7 x 5 cm in size was observed on the upper part of the right lung, and as a result of lung biopsy, squamous cell carcinoma (T41MO-phase 3b) was diagnosed. The patient had been smoking 10 cigarettes a day for 60 years and had been taking digoxin for heart insufficiency for 7 years. Biochemical laboratory analyses of the case were observed to be within normal limits and no findings of metastasis were obtained in ultrasonographic and tomographic scanning. In the dermatological examination, an ulceration on the apex nasi, 2 x 1.5 cm in size, covered with crusts, was observed. On the thorax, lesions parallel to one another, linearly distributed, partly pigmented and raised from the skin, having a diameter of 0.5-2 cm, were observed, consistent with seborrheic keratoses (Fig. 1). In addition to these lesions, symmetrically localized, velvety, slightly raised plaques with light brown pigmentation were present on the axillary folds (Fig. 2). Histopathological investigation of the incisional biopsy taken from the apex nasi revealed tumor islands of different sizes. Histopathological changes were found to be in accordance with solid-type basal cell carcinoma. In the histopathological investigation of the incisional biopsy taken from the lesion consistent with seborrheic keratosis, epidermal thickening consisting of basaloid cells and keratin cysts was observed, and the result of the biopsy taken from the axilla was acanthosis nigricans, showing hyperkeratosis, focal acanthosis and papillomatosis in the epidermis.
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Affiliation(s)
- Can Ceylan
- Department of Dermatology, University of Ege, Medical Faculty, Izmir, Turkey.
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Mekhail TM, Markman M. Acanthosis nigricans with endometrial carcinoma: case report and review of the literature. Gynecol Oncol 2002; 84:332-4. [PMID: 11812096 DOI: 10.1006/gyno.2001.6472] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Acanthosis nigricans is classified into benign and malignant forms on the basis of clinical associations. The main interest in acanthosis nigricans has been based on its association with malignancy because of the dramatic clinical appearance of the skin lesions and the usually rapidly fatal nature of the underlying disease. "Tripe palms" is a descriptive term of acanthosis nigricans of the palms. It more often is associated with internal malignancy. Most importantly, it often precedes the diagnosis of a new or recurrent tumor. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. There are very few reports in the literature of malignant acanthosis nigricans associated with gynecological malignancies. Only five cases of endometrial carcinoma associated with acanthosis nigricans and/or tripe palms have been reported in the literature. CASE A 69-year-old African-American female presented with skin changes consistent with the diagnosis of acanthosis nigricans and tripe palms. More than 14 months later she was found to have endometrial carcinoma. She subsequently underwent total abdominal hysterectomy and salpingo-oophorectomy followed by chemotherapy with paclitaxel and carboplatin. During treatment of the underlying malignancy the skin condition dramatically improved. CONCLUSION Tripe palms can be associated with endometrial carcinoma and may be the first sign of malignancy. Malignant acanthosis nigricans may improve with treatment of the underlying malignancy. Patients who present with tripe palms may need to undergo workup to search for underlying malignancy.
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Affiliation(s)
- Tarek M Mekhail
- Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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17
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Bottoni U, Dianzani C, Pranteda G, Innocenzi D, De Giacomo P, Balzani A, Zampetti M, Pala S, Calvieri S. Florid cutaneous and mucosal papillomatosis with acanthosis nigricans revealing a primary lung cancer. J Eur Acad Dermatol Venereol 2000; 14:205-8. [PMID: 11032067 DOI: 10.1046/j.1468-3083.2000.00051.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This is the report of an 80-year-old patient with diffuse brownish hyperpigmentation and velvety thickening of the skin with onset 1 year before. Warty lesions on his limbs were present as well as papillomatous and verrucous lesions on his lips, mouth and eyelid conjunctivae with hyperkeratosis of the nipples. Biopsies, performed at different sites, showed histological pictures consistent with a diagnosis of acanthosis nigricans (AN) with florid cutaneous and mucosal papillomatosis. This type of AN is frequently associated with internal malignancy. In our patient serum levels of tissue polypeptide antigen, carcinoembryonic antigen, cytokeratin fragment and squamous cell carcinoma antigen were high and chest computed tomography scan indicated a large tumour infiltrating the right lung and extending to the mediastinum. Cytological examination of bronchial drainage revealed the presence of neoplastic cells, non-small cell type carcinoma. The most frequent cancer associated with malignant AN is gastric adenocarcinoma. Lung tumour has rarely been reported with AN. Malignant AN is sometimes associated with other cutaneous and mucosal warty lesions, as in our patient. These various skin and mucosal lesions are the expression of a systemic epithelial disorder and may help clinicians to suspect a malignant form of AN.
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Affiliation(s)
- U Bottoni
- Istituto di Dermatologia, Università di Roma La Sapienza, Italy.
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Affiliation(s)
- R D Hardy
- Division of Pediatrics, University of Texas M.D. Anderson Cancer Center, Houston, USA
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19
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Brown Verrucous Plaques in the Axilla of a 59-Year-Old Woman. J Cutan Med Surg 1997. [DOI: 10.1177/120347549700100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
The sign of Leser-Trélat is rare. It is defined as the sudden eruption of multiple seborrheic keratoses caused by a malignancy. Because both seborrheic keratoses and cancer are common in the elderly, it is not always easy to tell from the literature or in any given patient if this sign is present. In fact, its validity has been questioned. Its association with malignant acanthosis nigricans is one of several of its features that support its legitimacy as a true paraneoplastic disorder.
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Affiliation(s)
- R A Schwartz
- New Jersey Medical School, Newark 07103-2714, USA
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21
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Abstract
OBJECTIVE To provide an overview of the clinical manifestations, pathophysiology, and oncologic implications of the cutaneous paraneoplastic syndromes that occur predominantly in patients with solid tumors. METHODS A review was performed of the literature identified by a comprehensive MEDLINE search. RESULTS Diverse cutaneous paraneoplastic syndromes may be associated with underlying tumors. They include musculoskeletal disorders (clubbing, hypertrophic osteoarthropathy, dermatomyositis, and multicentric reticulohistiocytosis), reactive erythemas (erythema gyratum repens and necrolytic migratory erythema), vascular dermatoses (Trousseau's syndrome), papulosquamous disorders (acanthosis nigricans, tripe palms, palmar hyperkeratosis, acquired ichthyosis, pityriasis rotunda, Bazex's syndrome, florid cutaneous papillomatosis, the sign of Leser-Trélat, and extramammary Paget's disease), and disorders of hair growth (hypertrichosis lanuginosa acquisita). The clinical manifestations of these dermatoses may precede, coincide with, or follow the diagnosis of cancer. The presence of a cutaneous paraneoplastic syndrome is often associated with a poor prognosis. CONCLUSIONS Cutaneous paraneoplastic syndromes are specific constellations of mucous membrane and/or skin abnormalities that are caused by an underlying tumor. Since they may be the presenting sign of an occult cancer, cognizance of their features and clinical implications are of considerable importance. Individuals with these syndromes should have a thorough workup for an associated malignancy.
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Affiliation(s)
- R Kurzrock
- Department of Clinical Investigation, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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22
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Abstract
Acanthosis nigricans is a mucocutaneous eruption that occurs in a strikingly exuberant form as a marker for a highly malignant and rapidly fatal internal cancer. Recently, it has been recognized that acanthosis nigricans may also be a relatively common marker for increased long-term risk of the less dramatic but potentially serious systemic disorders associated with insulin resistance and compensatory increased insulin secretion.
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23
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D'Souza M, Garg BR, Reddy BS, Ratnakar C. Lepromatous leprosy with extensive truncal seborrheic keratoses and acral verruca vulgaris. Int J Dermatol 1994; 33:498-500. [PMID: 7928035 DOI: 10.1111/j.1365-4362.1994.tb02864.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M D'Souza
- Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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24
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Yaniv R, Servadio Y, Feinstein A, Trau H. The sign of Leser-Trélat associated with transitional cell carcinoma of the urinary-bladder--a case report and short review. Clin Exp Dermatol 1994; 19:142-5. [PMID: 8050144 DOI: 10.1111/j.1365-2230.1994.tb01143.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Leser-Trélat sign is defined as the sudden appearance of multiple seborrhoeic keratoses in association with internal malignancy. Although 75 cases have been reported to date, controversy still exists about the significance of this sign. The first association of the Leser-Trélat sign with transitional cell carcinoma of the urinary-bladder is reported.
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Affiliation(s)
- R Yaniv
- Department of Dermatology, Chaim Sheba Medical Centre, Tel Hashomer, Ramat Aviv, Israel
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25
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Abstract
The keratoacanthoma is a common cutaneous neoplasm that most often occurs on sun-exposed sites in light-skinned persons of middle age or older. It is considered the prototype of cutaneous pseudo-malignancies because it is a rapidly growing tumor with a histologic pattern resembling squamous cell carcinoma. It may be best viewed as an aborted malignancy that only rarely progresses into an invasive squamous cell carcinoma. It is most likely derived from hair follicle cells. The common type of keratoacanthoma and its many variants are discussed with emphasis on clinical and histologic features, biologic behavior, and response to therapy.
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26
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Affiliation(s)
- W I Worret
- Department of Dermatology, Technical University, Munich, Germany
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27
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Worret WI, Mayerhausen W, Emslander HP. Hypertrichosis lanuginosa acquista associated with florid cutaneous papillomatosis. Int J Dermatol 1993; 32:56-8. [PMID: 8425806 DOI: 10.1111/j.1365-4362.1993.tb00968.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- W I Worret
- Department of Dermatology, Technical University, Munich, Germany
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Wilgenbus K, Lentner A, Kuckelkorn R, Handt S, Mittermayer C. Further evidence that acanthosis nigricans maligna is linked to enhanced secretion by the tumour of transforming growth factor alpha. Arch Dermatol Res 1992; 284:266-70. [PMID: 1444575 DOI: 10.1007/bf00372579] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The pathogenesis of cutaneous paraneoplastic syndromes is still under discussion. Since many of these syndromes, including acanthosis nigricans, are proliferative skin disorders it is believed that products secreted by the tumour stimulate the keratinocytes to proliferate. Growth factors like transforming growth factor alpha (TGF-alpha) are known to be highly mitogenic for keratinocytes in vitro. Here we report on a patient with a poorly differentiated gastric cancer and a full clinical picture of acanthosis nigricans characterized by diffuse hyperkeratosis and multiple papillomatous lesions of the skin with involvement of the conjunctivae. In Southern blot analysis of the tumour tissue from this patient amplification of the epidermal growth factor (EGF) receptor, the common ligand for TGF-alpha and EGF, was shown. Immunohistochemically, prominent staining was found throughout the tumour using anti-TGF-alpha antibodies. In a series of 25 investigated gastric tumour biopsies, four tumours showed amplification of the EGF receptor and one additional biopsy was positive for TGF-alpha. Since there is no other report describing the link between TGF-alpha and acanthosis nigricans, except that of Ellis et al. 1987, we present a new case suggesting a possible link between growth factors and acanthosis nigricans maligna.
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Affiliation(s)
- K Wilgenbus
- Institut für Pathologie, Rheinisch Westfälisch Technische Hochschule Aachen, Federal Republic of Germany
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Affiliation(s)
- P R Cohen
- Department of Dermatology, University of Texas Medical School, Houston
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