Cutaneous markers of internal malignancy.

What are they cutaneous intern markers malignancy?

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

Skin markers can be classified into 2 main types:

• Genetically determined syndromes with a cutaneous component (genodermatosis) that predispose individuals at risk of developing cancer
• Paraneoplastic syndromes that occur as a result of circulating factors or presumed factors produced by the underlying cancer

Genodermatosis

Skin diseases that belong to the group of genodermatoses include:

• Birt - Hogg - Dubé syndrome
• Cowden's disease
• Gardner syndrome
• Gorlin syndromebasal cell nevus syndrome)
• Multiple endocrine neoplasm type 2B
• Neurofibromatosis
• Peutz-Jeghers syndrome
• Torre-Muir syndrome

• Progeria (premature aging syndromes)

Paraneoplastic syndromes

Cutaneous paraneoplastic syndromes can be classified according to the type of injury they produce.

Papulosquamous

• Acanthosis nigricans
• Acquired ichthyosis
• Paraneoplastic acrokeratosis
• Extramammary Paget's disease
• Flowery cutaneous papillomatosis
• Palmoplantar keratoderma
• Pityriasis roundabout
• Leser-Trelat sign
• Callus palms

Erythematous

• Dermatomyositis
• Erythema Gyratum repens
• Hypertrophic osteoarthropathy and digital clubbing
• Multicentric reticulohistiocytosis
• Necrolytic migratory erythema
• Sweet disease
• Eosinophilic skin disease of hematological malignancy

Bullous

• Paraneoplastic pemphigus

Diverse

• Generalized granuloma annular (rarely)
• Granulomatous dermatitis
• Carcinoid syndrome
• Hypertrichosis Lanuginosa acquisita
• Trousseau syndrome

• Paraneoplastic pruritus (cancer itch)

In addition to skin signs and symptoms, paraneoplastic syndromes can affect the endocrine, neuromuscular, musculoskeletalcardiovascular hematological, gastrointestinal or renal function.

Paraneoplastic symptoms can be caused by:

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