Skin: A mirror of internal malignancy

Rita V Vora; RahulKrishna S Kota; Nilofar G Diwan; Nidhi B Jivani; Shailee S Gandhi

doi:10.4103/0971-5851.195730

Indian Journal of Medical and Paediatric Oncology, Table of Contents

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2016; 37(04): 214-222
DOI: 10.4103/0971-5851.195730

REVIEW ARTICLE

Skin: A mirror of internal malignancy

Authors

Rita V Vora

Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
RahulKrishna S Kota

Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
Nilofar G Diwan

Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
Nidhi B Jivani

Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India
Shailee S Gandhi

Department of Dermatology, Shree Krishna Hospital, Pramukh Swami Medical College, Karamsad, Gujarat, India

Abstract

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Abstract

Skin manifestations are a reflection of many of the internal diseases. Sometimes, skin disease may be the only manifestation of the internal disease. Internal malignancies may give rise to a number of cutaneous manifestations through their immunological, metabolic, and metastatic consequences. Curth proposed criteria to establish a causal relationship between a dermatosis and a malignant internal disease. Malignancy can present with a plethora of cutaneous manifestations. Here, we describe in brief about various skin manifestations of internal malignancies.

Keywords

Cutaneous manifestations - internal malignancy - paraneoplastic syndrome

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References

References
1 Nair PS, Nanda KG, Jayapalan S. The “sign of groove”, a new cutaneous sign of internal malignancy. Indian J Dermatol Venereol Leprol 2007;73:141.
2 Curth HO. Skin lesions and internal carcinoma. In: Andrade R, editor. Cancer of the Skin: Biology, Diagnosis, Management. Philadelphia: Saunders; 1976.
3 Rosen T. Cutaneous metastases. Med Clin North Am 1980;64:885-900.
4 Brownstein MH, Helwig EB. Patterns of cutaneous metastasis. Arch Dermatol 1972;105:862-8.
5 Tharakaram S. Metastases to the skin. Int J Dermatol 1988;27:240-2.
6 Chopra R, Chhabra S, Samra SG, Thami GP, Punia RP, Mohan H. Cutaneous metastases of internal malignancies: A clinicopathologic study. Indian J Dermatol Venereol Leprol 2010;76:125-31.
7 Shoup M, Brennan MF, Karpeh MS, Gillern SM, McMahon RL, Conlon KC. Port site metastasis after diagnostic laparoscopy for upper gastrointestinal tract malignancies: An uncommon entity. Ann Surg Oncol 2002;9:632-6.
8 Braverman IM. Skin manifestations of internal malignancy. Clin Geriatr Med 2002;18:1-19, v.
9 Reingold IM. Cutaneous metastases from internal carcinoma. Cancer 1966;19:162-8.
10 Provost TT. Cutaneous metastasis. In: Provost TT, Flynn JA, editors. Cutaneous Medicine: Cutaneous Manifestations of Systemic Disease. Hamilton, Ontario: Decker; 2001. p. 357-66.
11 Schwartz RA. Cutaneous metastatic disease. J Am Acad Dermatol 1995;33(2 Pt 1):161-82.
12 Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: A retrospective study of 4020 patients. J Am Acad Dermatol 1993;29(2 Pt 1):228-36.
13 Marcoval J, Moreno A, Peyrí J. Cutaneous infiltration by cancer. J Am Acad Dermatol 2007;57:577-80.
14 Weedon D. Skin Pathology. 2nd ed. London: Churchill Livingstone; 2002. p. 1045-56.
15 Kishore TA, Bhat S, John PR. Vesicocutaneous fistula arising from a bladder diverticulum. Indian J Med Sci 2005;59:265-7.
16 Dozois RR, Judd ES, Dahlin DC, Bartholomew LG. The Peutz-Jeghers syndrome. Is there a predisposition to the development of intestinal malignancy? Arch Surg 1969;98:509-17.
17 Bitar GJ, Herman CK, Dahman MI, Hoard MA. Basal cell nevus syndrome: Guidelines for early detection. Am Fam Physician 2002;65:2501-4.
18 Lynch HT, Fusaro RM, Pester J, Oosterhuis JA, Went LN, Rumke P, et al. Tumour spectrum in the FAMMM syndrome. Br J Cancer 1981;44:553-60.
19 Kraemer KH, Lee MM, Scotto J. DNA repair protects against cutaneous and internal neoplasia: Evidence from xeroderma pigmentosum. Carcinogenesis 1984;5:511-4.
20 Graham RM, Cox NH. Systemic disease and the skin. In: Burns T, Breathnach S, Cox NH, Griffiths C, editors. Rooks Textbook of Dermatology. 7th ed. Oxford: Blackwell; 2004. p. 59.1-59.75.
21 Cox NH, Coulson IH. Systemic disease and the skin. In: Burns T, Breathnach S, Cox NH, Griffiths C, editors. Rooks Textbook of Dermatology. 8th ed. West Sussex, UK: Wiley Blackwell; 2010. p. 62.30-62.45.
22 Salem OS, Steck WD. Cowden's disease (multiple hamartoma and neoplasia syndrome). A case report and review of the English literature. J Am Acad Dermatol 1983;8:686-96.
23 Khanna KK. Cancer risk and the ATM gene: A continuing debate. J Natl Cancer Inst 2000;92:795-802.
24 Callen JP. Skin signs of internal malignancy. In: Callen JP, Jorizzo JL, editors. Dermatological Manifestations of Internal Disease. 3rd ed. Philadelphia: Saunders; 2003. p. 95-104.
25 Poole S, Fenske NA. Cutaneous markers of internal malignancy. I. Malignant involvement of the skin and the genodermatoses. J Am Acad Dermatol 1993;28:1-13.
26 Poole S, Fenske NA. Cutaneous markers of internal malignancy. II. Paraneoplastic dermatoses and environmental carcinogens. J Am Acad Dermatol 1993;28(2 Pt 1):147-64.
27 Provost TT, Laman SD, Bell WR. Paraneoplastic dermatoses. In: Provost TT, Flynn JA, editors. Cutaneous Medicine: Cutaneous Manifestations of Systemic Disease. Hamilton, Ontario: Decker; 2001. p. 367-88.
28 Provost TT, Laman SD, Giardiello FM. Hereditary paraneoplastic syndromes. In: Provost TT, Flynn JA, editors. Cutaneous Medicine: Cutaneous Manifestations of Systemic Disease. Hamilton, Ontario: Decker; 2001. p. 389-400.
29 Roumm A, Medsger TJ. Cancer in connective tissue disease. Arthritis Rheum 1982;25:1130-3.
30 Cohen PR. Paraneoplastic dermatopathology: Cutaneous paraneoplastic syndromes. Adv Dermatol 1996;11:215-52.
31 Schwartz RA. Acanthosis nigricans. J Am Acad Dermatol 1994;31:1-19.
32 Ellis DL, Yates RA. Sign of leser-trélat. Clin Dermatol 1993;11:141-8.
33 Boyce S, Harper J. Paraneoplastic dermatoses. Dermatol Clin 2002;20:523-32.
34 Hill CL, Zhang Y, Sigurgeirsson B, Pukkala E, Mellemkjaer L, Airio A, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: A population-based study. Lancet 2001;357:96-100.
35 Gogia A, Kakar A, Bhalla S, Byotra SP. Leucocytoclastic vasculitis as a presentation of adenocarcinoma rectum. J Postgrad Med 2005;51:215-7.
36 Arkel YS. Thrombosis and cancer. Semin Oncol 2000;27:362-74.
37 Kurzrock R, Cohen PR. Erythromelalgia and myeloproliferative disorders. Arch Intern Med 1989;149:105-9.
38 Egan CA, Lazarova Z, Darling TN, Yee C, Coté T, Yancey KB. Anti-epiligrin cicatricial pemphigoid and relative risk for cancer. Lancet 2001;357:1850-1.
39 Bolognia JL, Brewer YP, Cooper DL. Bazex syndrome (acrokeratosis paraneoplastica). An analytic review. Medicine (Baltimore) 1991;70:269-80.
40 Worret WI, Mayerhausen W, Emslander HP. Hypertrichosis lanuginosa acquista associated with florid cutaneous papillomatosis. Int J Dermatol 1993;32:56-8.
41 Grob JJ, Rava MC, Gouvernet J, Fuentes P, Piana L, Gamerre M, et al. The relation between seborrheic keratoses and malignant solid tumours. A case-control study. Acta Derm Venereol 1991;71:166-9.
42 Provost TT, Flynn JA, editors. Cutaneous Medicine: Cutaneous Manifestations of Systemic Disease. Hamilton, Ontario: Decker; 2001.
43 Lebwohl MG. The Skin and Systemic Disease. A Color Atlas and Text. 2nd ed. London: Churchill Livingstone; 2004. p. 185-214.
44 Callen JP, Jorizzo JL, editors. Dermatological Signs of Internal Disease. 3rd ed. Philadelphia: Saunders; 2003.
45 Vardy DA, Sion N, Grunwald MH. Specific cutaneous infiltrates in chronic myelogenous leukemia. Cutis 1989;44:53-5.
46 Paul R, Paul R, Jansen CT. Itch and malignancy prognosis in generalized pruritus: A 6-year follow-up of 125 patients. J Am Acad Dermatol 1987;16:1179-82.
47 Feiner AS, Mahmood T, Wallner SF. Prognostic importance of pruritus in Hodgkin's disease. JAMA 1978;240:2738-40.
48 Graham RM. Aspects of itching. In: Verbov JL, editor. New Clinical Applications in Dermatology. Lancaster: MTP Press; 1987. p. 49-70.
49 Thomas I, Schwartz RA. Cutaneous paraneoplastic syndromes: Uncommon presentations. Clin Dermatol 2005;23:593-600.
50 Jackson N, Burt D, Crocker J, Boughton B. Skin mast cells in polycythaemia vera: Relationship to the pathogenesis and treatment of pruritus. Br J Dermatol 1987;116:21-9.
51 Pipkin CA, Lio PA. Cutaneous manifestations of internal malignancies: An overview. Dermatol Clin 2008;26:1-15, vii.
52 Yosipovitch G. Pruritus: An update. Curr Probl Dermatol 2003;15:135-64.
53 Johnson RE, Kanigsberg ND, Jimenez CL. Localized pruritus: A presenting symptom of a spinal cord tumor in a child with features of neurofibromatosis. J Am Acad Dermatol 2000;43(5 Pt 2):958-61.
54 Adreev VC, Petkov I. Skin manifestations associated with tumours of the brain. Br J Dermatol 1975;92:675-8.
55 Tyring SK. Reactive erythemas: Erythema annulare centrifugum and erythema gyratum repens. Clin Dermatol 1993;11:135-9.
56 Mclean DI, Haynes HA. Cutaneous manifestations of internal malignant disease: Cutaneous paraneoplastic syndromes. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrik's Dermatology in General Medicine. 6th ed. New York: McGraw-Hill; 2003. p. 1783-96.
57 Benedek TG. Paraneoplastic digital clubbing and hypertrophic osteoarthropathy. Clin Dermatol 1993;11:53-9.
58 Helm TN, Camisa C, Liu AY, Valenzuela R, Bergfeld WF. Lichen planus associated with neoplasia: A cell-mediated immune response to tumor antigens? J Am Acad Dermatol 1994;30(2 Pt 1):219-24.
59 Neittaanmäki H. Cold urticaria. Clinical findings in 220 patients. J Am Acad Dermatol 1985;13:636-44.
60 Nicolis GD, Helwig EB. Exfoliative dermatitis. A clinicopathologic study of 135 cases. Arch Dermatol 1973;108:788-97.
61 Grob JJ, Collet-Villette AM, Horchowski N, Dufaud M, Prin L, Bonerandi JJ. Ofuji papuloerythroderma. Report of a case with T cell skin lymphoma and discussion of the nature of this disease. J Am Acad Dermatol 1989;20(5 Pt 2):927-31.
62 Cohen PR. Granuloma annulare, relapsing polychondritis, sarcoidosis, and systemic lupus erythematosus: Conditions whose dermatologic manifestations may occur as hematologic malignancy-associated mucocutaneous paraneoplastic syndromes. Int J Dermatol 2006;45:70-80.
63 Davis MD, Perniciaro C, Dahl PR, Randle HW, McEvoy MT, Leiferman KM. Exaggerated arthropod-bite lesions in patients with chronic lymphocytic leukemia: A clinical, histopathologic, and immunopathologic study of eight patients. J Am Acad Dermatol 1998;39:27-35.
64 Ross JB, Tompkins MG. Cutis verticis gyrata as a marker of internal malignancy. Arch Dermatol 1989;125:434-5.
65 Burt RK, Sharfman WH, Karp BI, Wilson WH. Mental neuropathy (numb chin syndrome). A harbinger of tumor progression or relapse. Cancer 1992;70:877-81.