Dermatologic manifestations of malignancy

Yesterday we discussed some of the skin findings associated with internal malignancy.

Some of these are:

1) Acanthosis nigricans (shown above)
Hyperpigmented areas mainly on flexural surfaces. Associated with intraabdominal malignancy, most often gastric carcinoma

2) Dermatomyositis
May see Gottron's papules, heliotrope rash, shawl sign
~30% of cases are associated with underlying malignancy

3) The sign of "Leser-Trelat"
Acute onset of multiple seborrheic keratoses (often on the back) associated with GI adenocarimonas, lung, breast, and urinary tract cancers

4) Pyoderma gangrenosum
Classically occurs on extremities and is associated with IBD. Purulent ulcers, sometimes with cyanotic borders. Occasionally associated with multiple myeloma, non-Hodgkin's lymhoma, or solid tumors

5) Extramammary Paget's disease
Often affects anogenital area and sxillary skin; red, scaly plaques, often pruritic. 12% have internal malignancy, interestingly often physically close to area of Paget's (i.e. perianal is oten rectal ca; genital is often uterine/bladder/vaginal/prostate ca)

6) Sweet Syndrome
Erythematous, tender papules or plaques; may be diffuse (erythroderma). May be associated with hematologic malignancy (most often AML), or less commonly solid tumors

7) Carcinoid syndrome
75% of cases include facial flushing (other parts of the syndrome include dyspnea, wheezing, diarrhea). Most originate in GI tract, often appendiceal.

8) Inherited cancer syndromes

Cowden's disease- multiple hamartomas
Neurofibromatosis- cafe au lait spots; associated with optic gliomas, astrocytomas, acoustic neuromas

Click here for a good review on this topic