Systemic Presentations Flashcards
(14 cards)
What dermatological presentations are almost always due to cancer?
Carcinoid syndrome Paraneoplastic pemphigus Erythema gyratum repens Acquired trichosis lanuginosa Leser-trelat Bazex syndrome Ectopic ACTH syndrome Paget's/Extra-mammary Paget's
How does carcinoid syndrome present? What cancers can cause it?
Episodic flushing without sweat
Facial telangiectasia
Can be GI carcinoid (liver mets)
Bronchial, ovarian
How does paraneoplastic pemphigus present and what cancer can cause it?
Erosive stomatitis
Rash
Non-hodgkins
Castleman’s
How does erythema gyratum present and what cancer can cause it?
Concentric erythematous lesions
Variable sites and cancers
How does acquired trichosis lanuginosa present and what cancer can cause it?
Acute onset of lanugo hairs on face and body
Colorectal
Lung, breast, usually advanced
What is Leser-Trelat and what cancer can it signify?
Eruptive seborrheic keratoses
GI adenocarcinomas
What is Bazex syndrome and what can cause it?
Hyperkeratosis of extremities
Resembles psoriasis
Non-specific effects on skin biopsy
SCC - bronchial, oropharyngeal, GI
Gastric, colon, biliary adenocarcinomas
How does Ectopic ACTH syndrome present?
Generalised hyperpigmentation
ACTH > Increased MSH > increased release of melanin from melanocytes
How does Paget’s present?
Eczematous plaque at nipple/areola
Extension of underlying ductal adenocarcinoma
How does extra-mammary paget’s present?
Primary intraepithelial adenocarcinoma
Secondary to underlying visceral tumour (bladder, colon)
What conditions are strongly associated with cancer but not necessarily universal?
Acanthosis nigricans
Dermatomyositis
What is dermatomyositis?
Inflammatory and rash Periorbital heliotrope rash Gottron's papules - red maculo-papular over bony prominences Shawl sign Photosensitive poikiloderma Scalp erythema
What skin conditions may be associated with cancer but have no strong link?
Bullous pemphigoid Sweets syndrome Pyoderma gangrenosum Acquired ichthyosis Acquired angioedema Primary systemic amyloid Cryoglobulinaemia
What are some genetic tumour syndromes with dermatological signs?
Peutz-Jeghers - melanosis, colon hamartomas, colon cancer
Muir-Torre - sebaceous tumours, keratoacanthomas - GI/breast/GU cancers
Neurofibromatosis - cafe au lait, ax freckles, neurofibromas, nerve sheath - phaeochromocytoma, carcinoid
MEN syndromes - angiofibromas, neuromas, lichen or macular amyloid, endocrine presentation
Xeroderma pigmentosum - inability to repair sun damage, sarcoma, leukaemia, GI, lung cancer
Howel-Evans - palmaplantar keratoderma, oesophageal
