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Chap. 26 - SKIN SIGNS OF SYSTEMIC NEOPLASTIC DISEASES AND PARANEOPLASTIC CUTANEOUS SYNDROMES

Published online by Cambridge University Press:  07 September 2011

By
Kyrill Pramatarov
Edited by
Ronni Wolf ,
Batya B. Davidovici ,
Jennifer L. Parish  and
Lawrence Charles Parish
Kyrill Pramatarov
Affiliation:
University Hospital Lozenetz
Ronni Wolf
Affiliation:
Kaplan Medical Center, Rehovot, Israel
Batya B. Davidovici
Affiliation:
Kaplan Medical Center, Rehovot, Israel
Jennifer L. Parish
Affiliation:
Jefferson Medical College of Thomas Jefferson University
Lawrence Charles Parish
Affiliation:
Jefferson Medical College of Thomas Jefferson University
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Summary

THE SKIN MAY reflect many visceral diseases, malignancies included. Sometimes, the skin may even give a clue to the underlying neoplasm. The French dermatologist Delacrétaz has definded the term “paraneoplasia:”

Cutaneous paraneoplastic syndromes are nonmetastatic manifestations on the skin as a result of the existence of a malignant visceral tumor and/or disease of the lymphoma group, especially leukaemias. The close relation between the dermatosis and tumor is confirmed by the phenomenon of disappearance or not at all influenced skin disease, if the malignant tumor is eliminated by operation, irradiation or cytostatics. The recurrence of the skin changes (dermatosis) indicates a relapse of the tumor or metastases.

The paraneoplastic signs or syndromes may precede, appear parallel to, or follow the appearance of the internal malignancy. There are many classifications of the paraneoplastic signs and syndromes, utilizing a variety of criteria: Some of them are based on the morphology of skin changes, others are based on the frequency of the association of dermatosis/visceral malignancy. The paraneoplastic signs and syndromes may be divided into two groups: indirect associations and direct associations with parallel evolutions corresponding to the paraneoplastic syndrome. The pathogenesis of the development of paraneoplasias include:

  • peptides, mediators, and hormones released from the tumor;

  • immunological defense reactions induced by the tumor antigens and appearing after cross-reaction with the structures of the skin;

  • deposits of immunocomplexes of tumor antigens and antibodies; and

  • various cytokines and possibly growth factors.

Type
Chapter
Information
Emergency Dermatology , pp. 265 - 270
Publisher: Cambridge University Press
Print publication year: 2011

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