Cutaneous markers of internal malignancy

Author: Vanessa Ngan, Staff Writer, 2004. Updated by Amanda Oakley, Dermatologist, Hamilton, New Zealand, January 2016.


What are cutaneous markers of internal malignancy?

Skin changes can often be the first sign of a deeper problem including an internal malignancy. Signs of skin disease may precede, occur with, or follow the detection of an associated cancer. These skin diseases can be a feature of an undiagnosed cancer and may be the prompt for a thorough examination in patients. Or in a patient whose cancer is in remission, these skin diseases may be the initial sign of the cancer recurring.

Cutaneous markers can be classified into 2 major types:

  • Genetically determined syndromes with a cutaneous component (genodermatoses) that predispose at risk individuals to develop cancer
  • Paraneoplastic syndromes which occur as a result of circulating factor(s) or presumed factors produced by the underlying cancer

Genodermatoses

Skin diseases that come under the group of genodermatoses include:

Paraneoplastic syndromes

Cutaneous paraneoplastic syndromes can be categorised according to the type of lesion they produce.

Papulosquamous

Erythematous

Bullous

Miscellaneous

As well as cutaneous signs and symptoms, paraneoplastic syndromes may affect endocrine, neuromuscular, musculoskeletal, cardiovascular, haematological, gastrointestinal or renal function.

Paraneoplastic symptoms may be caused by:

  • Immune reaction: antibodies, T cells or cytokines
  • Hormones or hormone precursors
  • Enzymes
  • Embryonic or fetal proteins
  • Altered metabolic pathways
  • Unknown factors

 

Related Information

References:

  • Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.

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