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Paraneoplastic Dermatoses: A Clue for Underlying Malignancies.

Dario Didona1, Alessandra Rallo1,2, Andrea Carugno3

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Paraneoplastic dermatoses (PDs) are rare skin conditions that can signal hidden cancers. Early recognition of these cutaneous clues by dermatologists is crucial for timely diagnosis and improved patient prognosis.

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Area of Science:

  • Dermatology
  • Oncology
  • Internal Medicine

Background:

  • Paraneoplastic dermatoses (PDs) are rare, diverse skin conditions often presenting as the initial clinical manifestation of an underlying malignancy.
  • Familiarity with cutaneous signs of internal malignancies is essential for early diagnosis and improved patient outcomes.
  • This review highlights common and rare PDs, emphasizing diagnostic challenges and the importance of recognizing subtle skin changes.

Purpose of the Study:

  • To review various paraneoplastic dermatoses (PDs).
  • To emphasize the role of dermatologists in identifying cutaneous clues of underlying neoplasms.
  • To discuss specific PDs, including malignant acanthosis nigricans, necrolytic migratory erythema, paraneoplastic autoimmune multiorgan syndrome (PAMS), and paraneoplastic dermatomyositis.

Main Methods:

  • Literature review of paraneoplastic dermatoses.
  • Description of clinical features of selected PDs.
  • Classification of PDs into obligate and facultative categories.

Main Results:

  • Malignant acanthosis nigricans presents as velvety, hyperpigmented plaques in intertriginous areas.
  • Necrolytic migratory erythema is often misdiagnosed due to its similarity to seborrheic dermatitis.
  • Paraneoplastic autoimmune multiorgan syndrome (PAMS) is an obligate PD always linked to neoplasia.
  • Paraneoplastic dermatomyositis is a facultative PD, variably associated with cancer.

Conclusions:

  • Dermatologists must be adept at recognizing PDs as potential indicators of malignancy.
  • Timely identification of PDs can significantly improve the diagnostic timeline and prognosis for patients with cancer.
  • Understanding the spectrum of PDs, from common to rare, is vital for effective clinical management.