The Cutaneous Manifestations of the Functioning Carcinoid

Kierland, Robert R.

doi:10.1001/archderm.1958.01560010088011

Cited by 30 publications

(5 citation statements)

References 4 publications

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“…Rarely, ectopic ACTH and MSH‐like peptides can be produced by tumours and result in increased pigmentation. Hyperpigmentation of the skin, lips and palmar and plantar creases was reported in a patient with carcinoid flushing caused by a bronchial adenoma 61 …”

Section: Endocrine Disordersmentioning

confidence: 95%

Oral pigmentation

Lenane

Powell

2000

Acad Dermatol Venereol

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Oral pigmentation may be physiological or pathological in nature. It may represent a localized anomaly of limited significance or the presentation of potentially life-threatening multisystem disease. Evaluation of a patient with oral pigmentation requires a systematic approach with resource to appropriate investigations in certain circumstances. A full history of evolution of the pigmentary changes, as well as inquiring into family history, drug ingestion and systemic symptoms of concurrent disease are clearly important in the assessment. The duration, pattern, hue and distribution of colour changes can provide useful diagnostic clues. Special attention is given to newly appearing lesions, or those that have changed significantly in appearance, and biopsy may be needed to validate the clinical impression. This review should enable the reader to increase their familiarity with the assessment of oral pigmentation, the common causes of oral pigmentary change and the rarer disorders of pigmentation seen in this area. The systemic diseases that may give rise to oral pigmentation are detailed and the early signs of oral melanoma are highlighted, as well as the drugs which may cause pigmentary changes in this area and the different pattern of pigmentation they may induce.

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Section: Endocrine Disordersmentioning

confidence: 95%

Oral pigmentation

Lenane

Powell

2000

Acad Dermatol Venereol

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“…Nonetheless, symptoms vary depending on the site, since tumors originating in the embryological foregut (ie, stomach, lung, pancreas, and biliary tract) produce a certain characteristic tone described as bright salmon pink, while patients with tumors in the appendix or ileum develop a cyanotic coloration . As happened in this patient’s case, flushing episodes have been reported to become chronic and lead to the appearance of a severe rosacea with secondary phymatous changes …”

Section: Discussionmentioning

confidence: 73%

“…1,4 As happened in this patient'scase,flushingepisodeshavebeenreportedtobecomechronic and lead to the appearance of a severe rosacea with secondary phymatous changes. 2,[6][7][8] Other cutaneous manifestations that can arise in carcinoid syndrome are pellagroid lesions in relation to niacin deficit secondary to an excessive consumption of tryptophan directed to the overproduction of serotonin metabolites. 1,2 A specific variant of scleroderma affecting predominantly the lower extremities has also been described in carcinoid syndrome.…”

Section: Discussionmentioning

confidence: 99%

Leonine Facies, Flushing, and Systemic Symptoms

2017

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A man in his 50s with a history of both hypertension and a pulmonary tumor that was resected 10 years earlier (Figure , A) presented with generalized phymatous changes affecting his entire face, as well as a few pustular lesions and a diffuse erythema that gave him an appearance of leonine facies (Figure , B). He complained of substantial, progressive seborrheic hyperplasia and flushing episodes over the past year, accompanied by ocular manifestations that included swelling of his eyelids. Ophthalmological examination showed features of chronic blepharitis and lagophthalmos. Detailed anamnesis revealed a history of intense diarrhea in prior months. A biopsy specimen from the skin of the forehead was obtained and analyzed under hematoxylin-eosin staining (Figure , C). A computed tomography (CT) scan completed the etiological investigation (Figure , D). Resected lung tumor specimenA Forehead skin specimen C Liver CT image D Clinical presentation B Figure. A, Immunohistochemical analysis of the earlier lung tumor using chromogranin A; panoramic view shows that most of the cells diffusely express chromogranin (original magnification ×20). B, Leonine facies presentation shows phymatous changes, diffuse erythema, pustular lesions, and seborrheic hyperplasia. C, Forehead skin shows scarce lymphocytic infiltrate close to follicular structure along with sebaceous hyperplasia (hematoxylin-eosin, original magnification ×40). D, Liver computed tomographic (CT) image showing multiple metastatic hepatic masses. WHAT IS YOUR DIAGNOSIS? A. Leprosy B. Mastocytosis C. Carcinoid syndrome D. Leishmaniasis Clinical Review & Education

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“…Although induction of rhinophyma by long‐standing angiomata has not been reported previously, other causes of vasodilation have been associated with its development. Rosacea‐like changes have been noted in response to flushing and vasodilation secondary to the carcinoid syndrome 8–11,18 . These ranged from slight erythema with dilated veins, capillaries, and telangiectasias to areas of soft‐tissue hypertrophy with erythema, edema, and sebaceous gland hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

“…Facial flushing is usually the earliest manifestation, 4 and patients with rosacea have been shown to flush more often and more readily than control subjects 6,7 . Additionally, rosacea may develop in conditions associated with systemic causes of flushing, such as the functioning carcinoid syndrome, 8–11 and after the administration of vasodilative drugs 12 . We recently observed marked rhinophymatous skin change in association with the constant vasodilation existing in the area of a long‐standing cavernous hemangioma and postulate that the rhinophymatous skin change was induced secondary to long‐standing increased cutaneous blood flow.…”

mentioning

confidence: 99%