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Medicina Interna
Print version ISSN 0872-671X
Abstract
DUARTE, Joana Azevedo; MARCOS-PINTO, Ana and BORGES-COSTA, João. Cutaneous Paraneoplastic Manifestations of Hematological Malignancies. Medicina Interna [online]. 2017, vol.24, n.2, pp.138-145. ISSN 0872-671X.
The skin, as the largest organ of the human body, can have a key role in the early diagnosis of systemic diseases. Cutaneous manifestations can be the initial symptom of certain malignant hematological diseases (Hodgkin lymphoma, chronic lymphocytic leukemia, acute myeloid leukemia). These can be classified as specific when caused by direct invasion of malignant cells in the skin or by loco-regional expansion of the tumoral disease or unspecific when caused by the altered regulation of the immune system typical of oncologic patients (characterized by absence of neoplastic cells in the skin). The unspecific injuries are more frequent, have polymorphous appearance and may precede, follow or have a parallel course with the underlying malignancy. In this article, the most frequent cutaneous diseases associated with hematological malignancies are reviewed, namely neutrophilic dermatoses (Sweet syndrome and pyoderma gangrenosum), connective tissue diseases (dermatomyositis), pruritus of unknown origin and vesiculobullous disorders (pemphigus vulgaris and paraneoplastic pemphigus). Although less common, other diseases are also associated with malignancy such as amyloidosis, reactive erythemas, vascular dermatoses (livedo reticularis, erythromelalgia and vasculitis) and other disorders (acanthosis nigricans, sign of Leser-Trélat and acquired ichthyosis). The main purpose of this review is to highlight the relevance of cutaneous manifestations that can be the first symptom of hematological malignancies and lead to differential diagnosis.
Keywords : Hematologic Neoplasms; Paraneoplastic Syndromes; Skin Diseases.