Life-threatening paraneoplastic cutaneous syndromes

Stone, Stephen; Buescher, Lucinda

doi:10.1016/j.clindermatol.2004.06.011

Cited by 74 publications

(114 citation statements)

References 48 publications

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“…(8,11) Although the association between dermatomyositis and neoplasia is known, it remains poorly understood. (13)(14)(15)(16) Neoplasia can precede myositis, appear concomitantly, or be diagnosed after its clinical manifestation, with a higher frequency in the first three years after diagnosis. (7,13,(15)(16)(17) In some cases, dermatomyositis follows the clinical course of the underlying neoplasm, both manifesting concomitantly and the former improving with the treatment of the latter, which suggests a paraneoplastic relationship between the two.…”

Section: Discussionmentioning

confidence: 99%

“…(7,13,(15)(16)(17) In some cases, dermatomyositis follows the clinical course of the underlying neoplasm, both manifesting concomitantly and the former improving with the treatment of the latter, which suggests a paraneoplastic relationship between the two. (8,10,13,14,17) Determining the presence of occult neoplasia must be part of the investigation of every patient diagnosed with dermatomyositis. (13,15) In a retrospective analysis of 618 patients diagnosed with dermatomyositis, 198 cases of cancer were reported (32% of the patients), and, in 83 (7%) of the patients, the two diseases were diagnosed concomitantly.…”

Section: Discussionmentioning

confidence: 99%

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Adenocarcinoma pulmonar, dermatomiosite e síndrome miastênica de Lambert-Eaton: uma rara associação

et al. 2008

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The incidence of lung neoplasms is increasing in Brazil and in the world, probably as a result of the increase in smoking. Due to the greater number of cases, atypical presentations appear. We report the case of a 66-year-old hypertensive male smoker who presented progressive proximal muscular weakness and, in two months, evolved to dysphagia, dysphonia, and V-shaped skin lesions on the chest. A chest X-ray showed a spiculated pulmonary nodule in the right upper lobe. The biochemical analysis revealed elevated creatine kinase levels. After complementary tests and biopsies, the patient underwent right upper lobectomy. Histopathology showed a moderately differentiated adenocarcinoma. The overall analysis of the case and a review of the literature allow us to suggest that the clinical profile of the patient was a result of an overlap of two paraneoplastic syndromes (dermatomyositis and Lambert-Eaton myasthenic syndrome) secondary to lung adenocarcinoma.Keywords: Lung neoplasms; Paraneoplastic syndromes; Dermatomyositis; Lambert-Eaton myasthenic syndrome; Adenocarcinoma. ResumoA incidência das neoplasias pulmonares vem aumentando no Brasil e no mundo, provavelmente como resultado do aumento do tabagismo. Com o maior número de casos, surgem as apresentações atípicas. Relatamos o caso de um paciente do sexo masculino, 66 anos, tabagista e hipertenso, que apresentava quadro de fraqueza muscular proximal progressiva e, em dois meses, evoluiu com disfagia para alimentos sólidos, disfonia e lesões cutâneas em forma de "V" no tórax. O radiograma de tórax mostrou um nódulo pulmonar espiculado no lobo superior direito. A análise bioquímica revelou aumento da creatinoquinase. Após exames complementares e biópsias, o paciente foi submetido à lobectomia superior direita. A histopatologia evidenciou um adenocarcinoma moderadamente diferenciado. A análise global do caso e a revisão de literatura permitem sugerir que o quadro clínico do paciente era resultante da sobreposição de duas síndromes paraneoplásicas, a saber, a dermatomiosite e a síndrome miastênica de Lambert-Eaton, secundárias a um adenocarcinoma pulmonar.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma pulmonar, dermatomiosite e síndrome miastênica de Lambert-Eaton: uma rara associação

et al. 2008

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“…Dyskera to tic ke ra ti nocy tes, va cu o lar de ge ne ra ti on, bandli ke in fil tra ti on and me la nin in con tinen ce may be ra rely se en. 5,6,13,17 Our ca se his to pat ho lo gi cally had hyper ke ra to sis, pa ra ke ra to sis, acant ho sis and pe rivas cu lar lympho his ti ocy tic in fil tra ti on. In ad di tion, spon gi o sis, ba sal va cu o liza ti on, and es pe ci ally small pus tu lar chan ges that we re not se en in the simi lar ca ses in the pre vi o us li te ra tu re we re ob served.…”

Section: Dermatology and Venerologyunclassified

“…Ad di ti o nally, to pi cal and syste mic ste ro ids, sa licylic acid, to pi cal vi ta min D ana lo gu es, and PU VA are used in tre at ment. 5,6,16,17 Our ca se di ed shortly af ter star ting to pi cal cor ti cos te ro id tre at ment and the treatment co uld not be eva lu a ted.…”

Section: Dermatology and Venerologymentioning

confidence: 99%

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Pustular Bazex Syndrome with Flexural Localization Associated with Metastatic Lung Carcinoma: Case Report

Çiçek¹,

Kandı²,

Demir³

et al. 2011

Turkiye Klinikleri J Med Sci

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Erythema Gyratum Repens

Votquenne

Richert

2020

JAMA Dermatol

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A man in his 80s presented with a 2-year history of an asymptomatic, expanding eruption on the trunk and extremities. He denied any systemic symptoms. Physical examination revealed a serpiginous, erythematous eruption with a peripheral scale resembling wood grain (Figure). Histologic findings showed a perivascular lymphohistiocytic infiltrate with no deposition noted on a direct immunofluorescence assay. A workup for malignancy revealed a mass in the prostate with bilateral para-aortic and inguinal lymphadenopathy and an elevated level of prostate-specific antigen. The patient declined surgery and was lost to follow-up.Erythema gyratum repens (EGR) is a rare type of figurate erythema first described by John Gammel, MD, in 1952. 1 The rash has a characteristic appearance with erythematous concentric and parallel bands (wood grain pattern) and a collarette of scale. The typical distribution involves the trunk and proximal extremities but spares the hands, feet, and face. 2 Advancement of the rash is usually rapid. The mean age at diagnosis is in the seventh decade of life, with a 2:1 male-to-female ratio. 2 In approximately 70% of cases, EGR is considered a paraneoplastic condition. 2 Although in most patients the eruption precedes the diagnosis of an underlying neoplasm by several months, the rash may also present in those with an established malignant tumor. 3 The most commonly associated types of neoplasms are lung, esophageal, and breast cancer. 2 Figurate erythemas should be carefully considered in the differential diagnosis, as should other conditions that may present with EGR-like morphologic features, including resolving pityriasis rubra pilaris, ichthyosis, syphilis, lupus erythematosus, autoimmune blistering diseases, neutrophilic dermatoses, and cutaneous T-cell lymphoma.In EGR, histologic examination results are not specific and may reveal parakeratosis, spongiosis, and a perivascular lymphohistiocytic infiltrate in the papillary dermis. Deposits of immunoglobulin G, C3, and C4 may be observed in the basement membrane on an immunofluorescence assay. The exact pathogenesis of paraneo-plastic EGR is still debated, but an immune response triggered by the malignant neoplasm is suspected. 4 Given the high risk of paraneoplastic disease, cancer screening is strongly recommended. Patients should ensure that their routine cancer screening tests are updated and that appropriate symptoms are evaluated. If results of such studies are normal, thoracic imaging with chest radiography and computed tomography should be considered because of the association between EGR and thoracic malignant tumors. Patients should be advised to remain current with future cancer screening tests if no malignant neoplasm is detected.Neither immunosuppressive therapy nor retinoid treatment is effective against EGR. Resolution requires successful treatment of the underlying disease. 3

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Life-threatening paraneoplastic cutaneous syndromes

Cited by 74 publications

References 48 publications

Adenocarcinoma pulmonar, dermatomiosite e síndrome miastênica de Lambert-Eaton: uma rara associação

Adenocarcinoma pulmonar, dermatomiosite e síndrome miastênica de Lambert-Eaton: uma rara associação

Pustular Bazex Syndrome with Flexural Localization Associated with Metastatic Lung Carcinoma: Case Report

Erythema Gyratum Repens

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