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The skin frequently serves as a marker for underlying internal disease. The type of lesion typically relates to a specific disease or type of disease.
Internal
cancer:
Of patients with dermatomyositis, about 50% have associated breast, lung, ovarian, and GI cancers.
Acute onset of multiple seborrheic keratoses (Leser-Trélat sign) may indicate underlying internal cancer, particularly adenocarcinoma. However, because of the high prevalence of seborrheic keratoses in healthy adults, this sign may be overdiagnosed.
Acute febrile neutrophilic dermatosis is associated with hematologic cancer.
Acanthosis nigricans that is associated with cancer can be of rapid onset and particularly widespread. Pruritus without a clearly associated dermatitis may indicate occult cancer, often lymphoma.
Paraneoplastic pemphigus is a relatively rare autoimmune blistering disease that has been associated with various cancers, including leukemias.
The carcinoid syndrome (flushing and erythema of the neck) is associated with carcinoid tumor.
Erythema gyratum repens is a rare eruption consisting of concentric erythematous lesions, resembling wood grain, which has been associated with various cancers.
Endocrinopathies:
Many skin findings are associated with endocrinopathies but are not specific.
Patients with diabetes mellitus may have acanthosis nigricans, necrobiosis lipoidica, perforating disorders, and scleredema adultorum.
Thyroid disease, both hypothyroidism and hyperthyroidism, can affect hair, nails, and skin.
Cushing's disease causes striae distensae, moon facies, and skin fragility.
Addison's disease is characterized by hyperpigmentation that is accentuated in skin creases and areas of trauma.
GI disease:
Skin conditions commonly associated with GI diseases include:
Last full review/revision May 2009 by Robert J. MacNeal, MD
Content last modified May 2009
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