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Paraneoplastic Dermatoses at a Glance
  • Skin can be a marker for internal malignancy.
    • Epi-phenomenon.
    • Familial cancer syndromes.
    • Direct tumor extension.
  • Paraneoplastic dermatoses follow a parallel course with the malignancy and allow early diagnosis and monitoring.
  • Dermatoses with high associations with internal malignancy include tripe palms, Bazex syndrome, paraneoplastic pemphigus, erythema gyratum repens, necrolytic migratory erythema, and hypertrichosis lanuginose acquisita.
  • Weakly associated with internal malignancy are acanthosis nigricans, acquired ichthyosis, and multiple seborrheic keratoses.
  • Management of the dermatosis is the treatment of the malignancy.

Cutaneous manifestations of cancer can present with a variety of clinical findings that may reflect direct involvement of malignant cells, an epiphenomenon of a distant malignancy, or in the context of a familial cancer syndrome. The term “paraneoplastic dermatoses” refers to dermatoses (often unique) secondary to a distant cancer. There are two essential criteria: (1) the dermatosis must develop only after the development of the malignant tumor, even though some tumors may be asymptomatic and occult and (2) both the dermatosis and the malignant tumor follow a parallel course in that complete removal of the cancer results in clearing of the dermatosis and recurrence of the cancer causes relapse of the dermatosis. A suggested classification of clinicopathologic categories is shown in Table 153-1.

Table 153-1 Classic Paraneoplastic Dermatoses

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