Skin and Systemic Disease Flashcards
What cancer syndromes affect the skin?
Carcinoid Syndrome
Paraneoplastic pemphigus
Erythema Gyratum Repens
Acquired hypertrichosis
Leser Trelat
Bazex Syndrome
Ectopic ACTH
Pagets Disease
What are the skin features of carcinoid syndrome?
Episodic flushing, mins - hours (no sweating)
Facial telangiectasia
GI carcinoid = liver mets
Bronchial, ovarian = can occur with no liver mets
What are the skin signs of paraneoplastic pemphigus?
Erosive stomatitis
Rash
Non-hodgkins, Castlemans disease (produces the autoantibody)
What is erythema graytum repens?
Concentric erythematous lesions
Variable sites & types of malignancy
What is acquired hypertrichosis lanuginosa?
Acute onset of lanugo hairs at face and body
•Colorectal ca > lung > breast, usually advanced
What is leser-trelat?
Eruptive seborrhoeic keratoses
GI adenocarcinomas
What is Bazex syndrome?
- Hyperkeratosis of extremities
- Resembles psoriasis, non-specific fx on skin biopsy
What cancers are associated with Bazex syndrome?
- SCC: bronchial, oropharyngeal, GI
- Gastric, colon, biliary adenocarcinomas
What condition leads to generalised hyperpigmentation?
Tumour production of ACTH (ectopic ACTH syndrome)
Pigmentation also occurs in the mouth
•ACTH -> Inc. MSH -> release of melanin from melanocytes
What is pagets disease?
–Eczematous plaque at nipple / areola
–Extension of underlying ductal adenocarcinoma
The previous conditions until now have an underlying cancer in almost all cases
What is acanthosis nigricans?
Velvety hyperpigmentation of the skin of the skin
What is acanthosis nigricans associated with?
Strongly assocaited with gastric adenocarcinoma
Concern if:
Older patient, rapid onset
Other skin signs
Involves lips
Weight loss
What is dermatomyositis?
It is one of three inflammatory myopathies (can include muscle weakness)
•Inflammatory myopathy + rash
–Periorbital heliotrope rash
–Gottrons papules: red maculo-papular lesions over bony prominences
–Shawl sign
–Photosensitive poikiloderma
–Scalp erythema
What conditions may be asociated with malignancy?
Bullous pemphgoid
Sweets Syndrome
Pyoderma gangrenosum - this can be related to IBD or malignancy
Acquired ichthyosis
Acquired angioedema
Primary systemic amyloid
Cryoglobulinaemia - increase in the thickness of blood - blockage of small blood vesses