Multiple scalp metastases as a first manifestation of pancreatic adenocarcinoma

Alopecia neoplastica as a sign of visceral malignancies: a systematic review

“…68,69,72,77 The main colour of AN lesions was red-violaceous (66.7% -66/99), 2,4,6,8,9,12,13,15,17,20,21,27-29,34,40,42,43,46,47,50,53,55,57,59,61,63,65,67,68,70,71,73,75,76,78,80,83,85-89,91-93, 95-100,102,104,105,108-110,113,115-118,120,121 followed by flesh-coloured in 25.3% (25/99) 10,11,14,16,19,[23][24][25]32,33,36,45,48,49,51,54,58,62,64,74,79,81,84,101,114 and brown colour in 8.1% (8/99) of cases. 10,30,37,44,52,56,66,77 When reported, AN was asymptomatic in the majority of cases (78%; 21/27), with pain being reported in 22% of cases (6/27 cases). 21,32,42,56,69,117 According to the site on the scalp, in the majority of cases (70/94) only one site was involved, being the parietal area the most frequently reported with 19 cases, 30,31,<...>…”

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), 2,14,16,23,30,32,33,36,46,48,49,56,61,63,64,71,78,79,83,84,88,93,96,98,101,102,105,106,115,118 breast for 17.9% (22/123) of cases, 4,6,7,10,11,13,15,[17][18][19]26,27,29,34,35,37,44,66,67 kidney for 8.1% (10/123), lung for 7.3% (9/ 123), 25,38,43,<...>…”

“…According to gender distribution of primary tumours, we obviously found that the 100% of patients with uterus cancer (8/ 8) 64,65,84 while in 24.8% (30/121) cases, the diagnosis was synchronous. 7,8,18,20,23,31,33,35,44,46,48,56,68,69,72,73,[76][77][78]81,84,87,93,95,96,99,102,110,111 The specific sites of primary tumours in each of these subgroups were reported in Table S1 (Supporting Information). Considering cases diagnosed after the primary tumour, they were mainly derived from breast and GI cancers (18/88 cases each); synchronous cases prevalently had a GI origin (10/30 cases), while cases diagnosed before the primary tumour were only three (one from GI, namely one thyroid and one lung cancer).…”

“…Median time between primary tumour and AN diagnosis was 10 months (ranging from 0 to 240 months; IQR: 0-36). Finally, AN was the first metastatic event in 65 cases, 6,9,11,12,16,17,[19][20][21][22]24,28,34,36,37,39,41,51,54,56,60,62,67,70,72,[74][75][76][77]79,80,84,86,92,93,109,115,[117][118][119]121 with a median number of 1 lesion (ranging from 1 to 8) and a median diameter of 3 cm (ranging from 1 to 20 cm; IQR:1.5-4.7).…”

“…Ulceration (histologically diagnosed) was present in 31 out of 94 cases (33%), 13,15,26,[28][29][30][31]34,38,42,46,52,56,60,68,69,72,[76][77][78]80,84,92,95,97,102,106,109,114,116,117 with a higher incidence in AN related to lung cancer (4/5 cases). 68,69,72,77 The main colour of AN lesions was red-violaceous (66.7% -66/99), 2,4,6,8,9,12,13,15,17,20,21,27-29,34,40,42,43,46,47,50,53,55,57,59,61,63,65,67,68,70,71,73,75,76,78,80,83,85-89,91-93, 95-100,102,104,105,108-110,113,115-118,120,121 followed by flesh-coloured in 25.3% (25/99) 10,11,14,16,19,[23][24][25]32,33,36,45,…”