134: Cutaneous Paraneoplastic Syndromes Flashcards
(151 cards)
What are the characteristics of Acanthosis Nigricans?
Acanthosis Nigricans is characterized by symmetric hyperpigmentation, thickening and increased skin markings, commonly occurring in skinfold areas. Most common locations include axillae, neck, external genitalia, groin, face, inner thighs, antecubital and popliteal areas, umbilicus, and perianal regions.
What is the clinical significance of malignant Acanthosis Nigricans?
Malignant Acanthosis Nigricans can occur before, during, or after the detection of cancer and may indicate a potential association with neoplastic diseases.
What are the management strategies for Acanthosis Nigricans?
Management strategies include identifying underlying malignancy, topical keratolytics, oral retinoids, dietary interventions, cyproheptadine, and cosmetic treatments.
What are the common differential diagnoses (DDX) for Acanthosis Nigricans?
Common differential diagnoses include psoriasiform dermatitis, atopic dermatitis, pellagra, infections, and various pigmentary disorders.
What are cutaneous paraneoplastic syndromes?
Remote effects of underlying neoplastic diseases that are not direct effects of metastases or tumor invasion.
What is the significance of insulin in benign cutaneous paraneoplastic syndromes?
Insulin plays a significant role through IGF-1.
What are the clinical features of Acanthosis Nigricans?
Symmetric hyperpigmentation, thickening, and increased skin markings, often presenting as hyperpigmented velvety plaques.
What is the most common location for Acanthosis Nigricans?
Axillae, neck, external genitalia, groin, face, inner thighs, antecubital and popliteal areas, umbilicus, and perianal region.
What is the relationship between Acanthosis Nigricans and malignancy?
Malignant Acanthosis Nigricans can occur before, during, or after detection of cancer and parallels the course of the underlying malignancy.
What are some management strategies for Acanthosis Nigricans?
Identify underlying malignancy, use topical keratolytics, dietary fish oil, metformin, and other treatments like cyproheptadine and laser therapy.
What is the role of TGF alpha in malignant cutaneous paraneoplastic syndromes?
The tumor produces TGF alpha, stimulating keratinocyte proliferation and improving or resolving following treatment of underlying malignancy.
What are some differential diagnoses for Acanthosis Nigricans?
Psoriasiform dermatitis, atopic dermatitis, pellagra, infections like candidiasis, and other pigmentary disorders.
What is the typical appearance of the skin in Acanthosis Nigricans?
Darker skin pigmentation with a dirty appearance, thickening, and increased skin markings leading to hyperpigmented velvety plaques.
A patient presents with sudden, extensive acanthosis nigricans involving mucosal areas. What malignancy should be suspected?
The malignancy to suspect is intraabdominal adenocarcinoma, with gastric cancer being the most common.
What is the most common neoplasm associated with Acquired Ichthyosis?
Hodgkin disease is the most common neoplasm associated with Acquired Ichthyosis.
What are the clinical features of Tripe Palms?
Rough, thickened, and velvety palms with exaggerated dermatoglyphics, often coexisting with acanthosis nigricans.
What underlying conditions are associated with Pityriasis Rotunda?
Pityriasis Rotunda is associated with chronic diseases, infections, and malignancies, most commonly gastrointestinal hepatocellular cancer and hematologic malignancies.
What is the significance of sudden onset ichthyosis in adults?
Sudden onset of ichthyosis in an adult may be a presenting sign of underlying malignancy.
What is the management approach for Tripe Palms?
The management approach includes complete malignancy workup, radiographic evaluation, treating underlying malignancy, and potential improvement with oral retinoids.
What are the histopathological findings in Tripe Palms?
Histopathological findings include hyperkeratosis, acanthosis, papillomatosis, and may include dermal mucin and mast cells.
What is the typical demographic for Type 1 pityriasis rotunda?
Black or East Asian individuals.
What is the typical demographic for Type 2 pityriasis rotunda?
White individuals.
A patient with Hodgkin disease develops diffuse, symmetrical scaling on the trunk and extremities. What is the likely cutaneous paraneoplastic syndrome?
The likely syndrome is acquired ichthyosis, which is associated with Hodgkin disease and other malignancies.
A patient presents with tripe palms and acanthosis nigricans. What malignancy is most likely associated with this presentation?
The most likely associated malignancy is gastric cancer.