[Useful cutaneous markers of internal malignancy in the early stage]

Numerous skin changes are correlated with internal malignancy. These skin changes are collectively called dermadromes of internal malignancy or syndroma dermato-tumorale. The skin markers of internal malignancy can be classified into 1) skin metastasis, 2) paraneoplastic dermatoses, 3) cutaneous manifestations of the systemic carcinogenic disease process and 4) cancer-malformation syndrome. For diagnosis of the early stage of internal malignancy, paraneoplastic dermatoses are the most important among other skin changes. Above all, dermatomyositis, figurate erythemas, erythroderma and a number of bullous dermatoses (e.g., bullous pemphigoid, pemphigus vulgaris and dermatitis herpetiformis, Sweet' syndrome, pruritus, prurigo, acanthosis nigricans, Leser-Trélat sign, alopecia mucinosa, acquired ichthyosis, Bazex' syndrome, hypertrichosis aquisita lanuginosa) are among the paraneoplastic dermatoses. A total of 405 cases of syndroma dermato-tumorale except cases of skin metastasis were reported for recent 7 years (1980-1986) only in the dermatological field in Japan. Among them, cases of paraneoplastic dermatoses number 354 accounting for the majority. Finally, brief consideration is given to the relationship between the above mentioned skin manifestations and internal malignancy.