Paraneoplastic dermatological manifestation of gastrointestinal malignancies

Possible skin lesions:
- Acanthosis nigricans
- Florid papillomatosis
- Necrolytic Migratory Erythema
- Palmoplantar keratoderma
- Pancreatic panniculitis
- Paraneoplastic acrokeratosis
- Pityriasis rotunda
Clinical Symptoms
Paraneoplastic acrokeratosis (otherwise known as Bazex syndrome) – lesions similar to psoriasis or eczema are characteristic scaly patches of purple hue. Nail damage is also possible.
Localization:
- Hands, feet, knees, ears, nose and cheeks
- May be around the nails or damage to the nails themselves

Acanthosis nigricans:characteristic pigmented, velvety textured plaques (larger areas of palpable skin bumps)
Localization:
- Typically on bending surfaces
- Other places: back of the neck, armpits, groin

Necrolytic Migratory Erythema: characterized by migrating annular erythema (ring-shaped red spot), may be accompanied by lesions of the superficial skin layer and scabs.
Localization:
- Body folds – in the torso, groin, buttocks, thighs
- May be around the mouth area

Florid papillomatosis
sudden onset is characterized by abundant papillomas (warts) resembling viral warts. Growths are small in size (1-3 mm in diameter), with time they spread to other areas of the body. Itching occurs in 50% of cases.
Localization:hands, feet, knees, ears, nose and cheeks.

- Pink or light brown in color
- Hyperpigmented (darker than skin color) – if the skin is dark. Hypopigmented (lighter than skin color) – if the skin is light.
Localization: torso and limbs

Localization: palms and soles

Localization: legs, torso, buttocks

Certain criteria are used to assess whether the skin disease is a paraneoplastic syndrome:
- Neoplasia and paraneoplasia begin at the same or similar time
- Parallel course of conditions (as the tumor mass decreases, skin damage also decreases or vice versa)
- Signs of a skin condition are not part of a genetic syndrome
- A certain malignancy is associated with a certain paraneoplastic skin disease
- A rare prevalence of skin disease in the general population
- A frequent association between neoplasia and paraneoplasia
The doctor personally prepares the most suitable treatment plan for each patient depending on the specific manifestation of the paraneoplastic syndrome and the underlying cancer. The main method of treatment is to remove the neoplasia that caused the paraneoplastic syndrome. This may include surgery, chemotherapy, radiotherapy or other malignancy-specific treatment methods. Treatment that suppresses specific symptoms may help to improve the overall condition.

Pityriasis rosea
An acute, self-limiting, exanthematic skin disease that manifests as itchy, somewhat inflammatory, scaly rashes, usually on the torso, chest, and upper limbs.
Peeling skin syndrome
Peeling skin syndrome is a genetic disorder characterized by constant peeling of the skin. The disease appears from birth or in the first year of life
lasts a lifetime
Mycosis Fungoides
The most common primary skin T-cell lymphoma (cancer of the blood). Mycosis Fungoides is characterized by three main stages, several of which may exist at the same time