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![Erythema gyratum repens (left) and erythema annulare centrifugum (right). [Copyright: ?2018 Caccavale et al.]](publication/327089171/figure/fig2/AS:661649493094401@1534760940411/Erythema-gyratum-repens-left-and-erythema-annulare-centrifugum-right-Copyright.png)
Erythema gyratum repens (left) and erythema annulare centrifugum (right). [Copyright: ?2018 Caccavale et al.]
Source publication
Dermatological paraneoplastic syndromes are a group of cutaneous diseases associated with malignancy, but not directly related to the primary tumor itself or to its metastases. It is of utmost importance for the dermatologist to recognize the major cutaneous paraneoplastic syndromes to diagnose the underlying tumors that trigger them as early as po...
Contexts in source publication
Context 1
... serpiginous bands are arranged in a parallel con- figuration of red swirls over most of the body, producing con- centric figures that resemble a wood surface ("wood-grained" appearance) (Figure 2). The edges of the lesions migrate at a rapid rate, about 1 cm/day. ...
Citations
... По данным исследователей ДПС встречаются примерно у 7-15 % пациентов онкологическими заболеваниями, при этом развитие ДПС может как предшествовать диагностике злокачественного новообразования, так и возникать на поздних стадиях онкологического процесса или быть первым признаком рецидива [1]. Своевременная диагностика и правильная интерпретация ДПС могут привести к более раннему выявлению злокачественных новообразований и увеличению продолжительности жизни пациентов. ...
Examination of the skin is a widely available and simple method of examining the patient, which nevertheless allows you to diagnose systemic disorders and diseases in the human body at an early stage. A doctor of any specialty may encounter dermatological paraneoplastic syndromes in his practice, which are a group of skin diseases associated with malignant neoplasms, but not directly related to the primary tumor or its metastases. Timely analysis of dermatological paraneoplastic syndromes makes it possible to suspect malignant tumors that cause them and urgently refer the patient to an oncologist for the purpose of early diagnosis and treatment of a potentially curable oncological disease. In clinical practice, paraneoplastic Leser-Trélat syndrome is very common, which is manifested by the sudden appearance of multiple seborrheic keratomas (mainly in the back and abdomen) and an increase in their number and size over a short period of time (weeks, months). Treatment of this syndrome can be carried out both simultaneously and after treatment of the underlying malignant disease. Dermatological paraneoplastic syndromes require further in-depth study to understand the pathogenesis, create a clear classification and develop algorithms for the doctor’s actions in case of their detection.
... Paraneoplastic acrokeratosis (Bazex syndrome) is a rare skin disorder of unknown pathogenesis that typically affects men older than 40 years 1 . The common histopathology is psoriasiform, however other non-psoriasiform features have been described 1 . Clinically, it is characterized by symmetrical erythematous squamous lesions involving the acral sites 2 . ...
... At the advanced stage, the lesions may affect the upper/lower limbs, face, and scalp, with a centripetal distribution 2 . Cutaneous findings are usually noticed before the diagnosis of the underlying malignancy, more frequently squamous cell carcinomas of the upper aerodigestive tract or metastasis to cervical lymph nodes 1 , although other malignancies have been reported [1][2][3] . Differential diagnosis includes psoriasis/chronic eczema 2 . ...
Objective:
Bazex syndrome is a rare paraneoplastic skin disorder of unknown pathogenesis. Cutaneous findings are usually noticed before the diagnosis of the underlying malignancy, more frequently squamous cell carcinomas of the upper aerodigestive tract or metastasis to cervical lymph nodes. Association with other malignancies has been reported.
Case report:
Herein, we describe a case in course of metastatic papillary thyroid carcinoma and review the relevant literature.
Results:
A bibliographic search was conducted and a total of 8 studies concerning the association were reviewed.
Conclusions:
Physicians be aware of unexpected cutaneous conditions as a possible sign of underlying tumors.
... Cutaneous symptoms may precede, accompany or occur after the discovery of the neoplasm and disappear after removal of the tumour. (92). ...
... The differential diagnosis should be established with erythema annulare centrifugum, pustular psoriasis, acrodermatitis enteropathica, pellagra, seborrheic pemphigus, toxic epidermal necrolysis and subcorneal pustulosis. (92) Erythema annulare centrifugum consists of migratory annular eruption that can be associated with neoplasms such as bronchial carcinoid tumour, lymphomas, malignant histiocytosis and prostate adenocarcinoma. Annular lesions with raised erythematous margins and desquamation progressively appear in the periphery, which rapidly grow and form serpiginous figures. ...
Paraneoplastic syndromes (PNS) are a group of disorders that can affect the oncologic patient, and which are not directly attributable to tumour invasion, tumour compression or metastasis. In fact, they are due to tumour secretion of functional hormones or peptides or are related to immune cross-reactivity with the host tissue. These syndromes are called paraneoplastic because the components that cause them do not derive from the organ or tissue of origin, but from the neoplasm suffered by the patient. It is estimated that 10-15% of people with cancer suffer from a PNS.(1)
PNS is the second direct cause of death (27% of cases) in cancer patients, after cancer itself. Consequently, it is of remarkable importance to recognize and treat SPNs specifically.(2)
In view of the above, the aim of this article is to review the state of the art in neurological, haematological, endocrine, and dermatological paraneoplastic syndromes. It is a review in which the most relevant PNS and their symptomatology are described, inquiring into their diagnosis and treatment.
... In ihrer Übersichtsarbeit von 2012 identifizierten Chodkiewicz et al. 40 Patienten mit Malignitäts-assoziiertem EAC, wobei 62,5 % einen lymphoproliferativen und 37,5 % einen soliden Tumor hatten. Die Autoren schlugen vor, dass der zugrundeliegende maligne Prozess zur Bildung von Zytokinen oder Antigenen führt, welche die Entwicklung von Hautveränderungen wie EAC begünstigen [12][13][14][15][16]. ...
Zusammenfassung
Figurierte Erytheme (FE) sind eine ätiopathophysiologisch heterogene Gruppe von Erkrankungen mit typischen anulären erythematösen Hautveränderungen. Die Diagnose wird in erster Linie aufgrund des klinischen Bildes in Verbindung mit histologischen Befunden gestellt; oft handelt es sich um Ausschlussdiagnosen. Während einige Autoren FE eher als Reaktionsmuster denn als eigenständige klinische Entitäten betrachten, identifizierten andere vier klassische FE: Erythema anulare centrifugum, Erythema gyratum repens, Erythema migrans und Erythema marginatum. Die Differenzialdiagnosen der FE sind vielfältig und oft schwierig. Wir schlagen daher einen diagnostischen Algorithmus für FE vor, der die Diagnosen nach zeitlicher Entwicklung und klinisch-histologischem Phänotyp der verschiedenen Subtypen unterscheidet. Da einige FE in Verbindung mit Malignomen auftreten können, sind umsichtige Ärzte beim Umgang mit diesen Entitäten gefragt.
... In their review of 2012 Chodkiewicz et al. identified 40 patients with malignancy associated EAC with 62.5 % of lymphoproliferative and 37.5 % of solid tumor origin. They proposed that the underlying malignant condition leads to the formation of cytokines or antigens, stimulating the development of cutaneous eruptions like EAC [12][13][14][15][16]. However, in most EAC cases no causative trigger can be detected, resulting in a label of idiopathic EAC. ...
Figurate erythemas (FE) represent an etiopathophysiologically heterogeneous group of diseases defined by their characteristic annular erythematous skin lesions. Diagnosis is made primarily by clinical examination together with histological findings; often it is a diagnosis made by exclusion. While some authors discuss FE as clinical reaction pattern rather than distinct clinical entities, others identify four classic FE: erythema annulare centrifugum, erythema gyratum repens, erythema migrans and erythema marginatum. The differential diagnoses of FE are numerous and often challenging. We therefore present a potential diagnostic algorithm for FE that discriminates the differentials according to their temporal evolution and the clinical/histological phenotype of the various subtypes. Since some FE may present with an underlying malignancy, diligent clinicians are needed when dealing with those entities.
... Dermatología Revista mexicana falángicas) o los párpados en heliotropo (edema y eritema periorbitario) son patognomónicos, pero no siempre se encuentran en todos los pacientes, también pueden coexistir telangiectasias en los pliegues ungueales o signo de Samitz (cutículas de apariencia irregular) u otras alteraciones menos comunes como fotosensibilidad. 4,7,30,35,37 Bohan y Peter proponen unos criterios diagnósticos basados en las características clínicas y estudios de laboratorio (Cuadro 3); para establecer el diagnóstico se requiere cumplir con los criterios 3 y 5, la suma de otros dos criterios diferentes hace que el diagnóstico sea probable. 38 Para establecer el tratamiento del paciente es necesario considerar diversos factores e individualizar a cada paciente; la terapia inmunosupresora es esencial como parte del tratamiento; sin embargo, al momento no existe un consenso sobre el tratamiento estándar. ...
... La prevalencia de esta enfermedad es similar en mujeres y hombres, es más común en individuos que cursan la sexta década de la vida. [37][38][39][40] El eritema migratorio necrolítico forma parte de la tríada del síndrome de glucagonoma, también conformado por pérdida de peso y diabetes mellitus. El eritema migratorio necrolítico es la manifestación clínica principal de este síndrome, se caracteriza por eritema maculopapular rosado con bordes irregulares y lesiones anulares o arciformes dolorosas y pruriginosas, afectando en la mayoría de casos zonas como la ingle, el área perianal, el abdomen inferior y las piernas; posteriormente estas lesiones progresan a vesículas y ampollas que pueden formar costra o erosionarse, por lo que en algunos pacientes pueden observar diferentes tipos de lesiones por las diversas etapas de éstas, también se ha evidenciado estomatitis, glositis y queilitis angular; otros hallazgos del síndrome de glucagonoma son la pérdida de peso, diarrea, anemia y manifestaciones tromboembólicas. ...
... El eritema migratorio necrolítico es la manifestación clínica principal de este síndrome, se caracteriza por eritema maculopapular rosado con bordes irregulares y lesiones anulares o arciformes dolorosas y pruriginosas, afectando en la mayoría de casos zonas como la ingle, el área perianal, el abdomen inferior y las piernas; posteriormente estas lesiones progresan a vesículas y ampollas que pueden formar costra o erosionarse, por lo que en algunos pacientes pueden observar diferentes tipos de lesiones por las diversas etapas de éstas, también se ha evidenciado estomatitis, glositis y queilitis angular; otros hallazgos del síndrome de glucagonoma son la pérdida de peso, diarrea, anemia y manifestaciones tromboembólicas. 30,[37][38][39][40] Debido a que el eritema migratorio necrolítico está muy relacionado con el glucagonoma, para establecer el diagnóstico acertado Dermatología R e v i s t a m e x i c a n a deben realizarse diversos estudios, entre ellos la determinación de las concentraciones séricas de glucagón (suelen estar bastante elevadas), las concentraciones séricas de glucosa también son esenciales para determinar la diabetes mellitus, otros exámenes, como hemograma, concentraciones de insulina, calcio, hormona paratiroidea, péptido intestinal vasoactivo y prolactina pueden hacerse en el contexto de cada paciente. La tomografía computada contrastada de abdomen es el estudio de imagen de elección para determinar la existencia y localización del glucagonoma, para estudios de pronóstico y para descartar metástasis, se recomienda la gammagrafía de receptores de somatostatina. ...
alignant tumors can produce alterations distant from the primary tumor and its metastases. These alterations are known as paraneoplastic syndromes and are defined as the set of symptoms and signs that occur with an increased frequency in cancer patients and that are not directly related to the primary neoplasia or its metastases, nor are they a consequence of infections, metabolic or nutritional disorders, or the toxicity of the different oncological therapies prescribed. The cutaneous manifestations that are associated with internal malignancy can be divided into paraneoplastic dermatoses, inherited syndromes associated with skin disorders, and locoregional or distant malignancy and metastases. Clinicians must be familiar with paraneoplastic dermatoses to establish the diagnosis of the underlying neoplasia. Lack of familiarity can delay the diagnosis and treatment of cancer. In this review, some of the most common paraneoplastic dermatoses and their prognostic implications are described.
... Other disorders include porphyria, brain injury, HIV/AIDS, thyroid disease, and Cushing syndrome. Medicationassociated hypertrichosis can occur with cyclosporine, glucocorticoids, penicillamine, interferon, minoxidil, and cetuximab [5,6]. ...
... In die größere zweite Gruppe fallen häufiger auftretende Hautkrankheiten verschiedener Ätiologie, über deren Erscheinen als paraneoplastisches Phänomen in der Literatur wiederholt berichtet wurde (fakultative PD; . Tab. 2; [3] [6]. Das Krankheitsbild ist vermutlich das Ergebnis der Wirkung von Tumorsynthesefaktoren ("transforming growth factor", "insulin-like growth factor-1", Fibroblastenwachstumsfaktor) auf Keratinozyten. ...
Skin diseases represent the second most common paraneoplastic manifestations after endocrine disorders. Paraneoplastic dermatoses may arise as the first clinical sign of occult malignancies, or manifest during the course of a previously diagnosed neoplasm. Dermatoses belonging to the group of obligate paraneoplastic syndromes manifest only in the presence of underlying malignancies. Other skin diseases may be associated with malignancy in a subset of patients.
... Annular lesions may follow, accompany or precede the malignancy. 1,4 Clinicopathological analysis of 66 EAC cases found that 13% of the cases were associated with internal malignancies 5most commonly lymphoproliferative, followed by solid tumours (prostate adenocarcinoma, breast cancer, nasopharyngeal carcinoma, colon carcinoma, ovarian carcinoma, lung carcinoid and lung carcinomas (NSCLC and SCLC)). It is suggested that pathogenesis of EAC occurs possibly through T helper 1 cell-mediated reaction and tumour necrosis factor alpha, as well as proinflammatory cytokines. ...
... 7 Most lung cancers do not cause any symptoms until they have spread, but some patients do have paraneoplastic syndromes (Bazex syndrome, dermatomyositis, vasculitis, acanthosis nigricans, paraneoplastic bullous pemphigoid, acanthosis palmaris, hyperpigmentation of palms, acquired reactive perforating collagenosis, digital ulcers, tripe palms, erythema elevatum diutinum, Sweet's syndrome and paraneoplastic porphyria cutanea tarda). 4 To the best of our knowledge, the second case of EAC with SCCL is presented. The authors believe that PEACE in lung cancer is much more frequent than reported in the literature. ...
Erythema annulare centrifugum (EAC) is a chronic reactive form of annular erythema characterized by annular, arciform, and polycyclic erythematous plaques. The lesion usually lasts for a few weeks to a few months, migrating centrifugally with central clearing. EAC was first described by Darier in 1916 and classified in 1978 by Ackerman into superficial and deep type. The superficial form has minimally elevated “trailing scale” while the deep form is presented by non‐scaly and non‐pruritic lesions with indurated borders.
