Visual diagnosis of hematologic and oncologic diseases

Area of Science:

• Oncology
• Dermatology
• Emergency Medicine

Background:

• Cancer-related symptoms frequently present to emergency physicians, often with challenging, nonspecific signs.
• Dermatologic manifestations of cancer include paraneoplastic syndromes and skin metastases, which can indicate poor prognosis.

Purpose of the Study:

• To review the diverse dermatologic presentations of cancer encountered in emergency medicine.
• To highlight key features distinguishing benign from malignant skin lesions and metastatic disease.

Main Methods:

• Review of common and uncommon cancer-related dermatologic conditions.
• Analysis of clinical presentation, diagnostic indicators, and prognostic implications.
• Discussion of specific malignancies including basal cell carcinoma, squamous cell carcinoma, melanoma, Kaposi's sarcoma, and bone metastases.

Main Results:

• Dermatologic paraneoplastic syndromes manifest variously, including changes in skin color, texture, and hair growth, or hormone-related conditions like acne and hirsutism.
• Skin metastases, though uncommon, typically appear on the head, neck, chest, or abdomen and signify advanced disease.
• Malignant skin lesions (e.g., melanoma, basal cell carcinoma, squamous cell carcinoma) have characteristic features, but atypical presentations occur.
• Bone lesions suggestive of malignancy exhibit specific radiographic findings like irregular periosteal reaction and moth-eaten destruction.

Conclusions:

• Suspicious skin and bone lesions require thorough investigation for underlying malignancy.
• Prompt recognition of dermatologic signs of cancer is vital for timely diagnosis and management.
• Understanding the varied presentations of skin cancer and metastases improves emergency physician diagnostic capabilities.