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The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
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Dermis
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The papillary and reticular dermis are the two layers of the dermis. They are made of connective tissue with fibers of collagen extending from one to the other, making the border between the two somewhat indistinct. The dermal papillae extending into the epidermis belong to the papillary layer, whereas the dense collagen fiber bundles below belong to the reticular layer.
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Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
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Peritumoural leukoderma.

K Pavithran

    Indian Journal of Dermatology, Venereology and Leprology
    |February 18, 2017
    PubMed
    Summary
    This summary is machine-generated.

    Leukoderma, or white patches on the skin, was observed around metastatic nodules in two patients. This peritumoral leukoderma preceded the spontaneous regression of some metastatic nodules, suggesting an immune response.

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    Area of Science:

    • Dermatology
    • Oncology
    • Immunology

    Background:

    • Metastatic cutaneous nodules can present as multiple skin deposits.
    • Undifferentiated carcinoma of unknown primary and melanoma are significant oncologic diagnoses.
    • Leukoderma (vitiligo) is an autoimmune condition affecting melanocytes.

    Observation:

    • Two patients with metastatic skin nodules developed leukoderma surrounding the lesions.
    • One patient had melanoma of the sole, while the other had undifferentiated carcinoma of unknown primary.
    • The female patient experienced spontaneous regression of two metastatic nodules following leukoderma development.

    Findings:

    • Peritumoral leukoderma may be associated with the regression of cutaneous metastases.
    • The development of leukoderma around metastatic nodules suggests a potential host immune response.
    • This phenomenon warrants further investigation into the mechanisms of tumor regression.

    Implications:

    • Understanding the link between leukoderma and tumor regression could lead to novel immunotherapeutic strategies.
    • Further research may elucidate the immunological mechanisms driving this response.
    • This case series highlights a rare but potentially significant interaction between cutaneous metastases and the immune system.