Paraneoplastic Dermatoses: A Brief General Review and an Extensive Analysis of Paraneoplastic Pemphigus and Paraneoplastic Dermatomyositis
Abstract
1. Introduction
2. Obligate Paraneoplastic Dermatoses (PD)
2.1. Acanthosis Nigricans (AN)
2.2. Tripe Palms (TP)
2.3. Necrolytic Migratory Erythema (NME)
2.4. Paraneoplastic Pemphigus (PNP)
3. Facultative Paraneoplastic Dermatoses (PD)
3.1. Leser-Trélat (LT)
3.2. Pyoderma Gangrenosum (PG)
3.3. Sweet Syndrome (SS)
3.4. Paraneoplastic Dermatomyositis (PNDM)
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Criterion |
---|
1. The onset of dermatosis must be near to the beginning of the neoplasia |
2. Both must follow parallel courses |
3. The dermatosis must not be part of any genetic syndrome |
4. A specific dermatosis accompanies a specific tumor |
5. The cutaneous disease is rare in general population |
6. There is a high grade of association with the neoplasia |
Paraneoplastic Dermatosis | Involved Molecular Factors and Detected Antibodies |
---|---|
Acanthosis nigricans [1,2,3] | FGF, IGF-1, MSHα, TGF-α |
Tripe palms [1,2,3] | EGF-α and TGF-α |
Necrolytic migratory erythema [1,2,3] | Increased level of arachidonic acid and deficit of niacin |
Paraneoplastic pemphigus [1,2,3] | Circulating autoantibodies against α-2-macroglobulin-like-1, bullous pemphigoid antigen, desmocollins 1 and 3, desmogleins 1 and 3, desmoplakins 1 and 2, envoplakin, and periplakin, and plakophilin 3 |
Leser-Trélat [1,2,3] | EGF-α, IGF-1, and TGF-α |
Pyoderma gangrenosum [1,2,3] | Fas, FasL, IL1b, IL-8, IL-17, IL-23 |
Sweet syndrome [1,3,4,5] | G-CSF, GM-CSF, IL-1, IL-3, IL-6, IL-8 |
Paraneoplastic dermatomyositis [1,2,3] | Circulating autoantibodies against NXP-2 and TIF1-γ |
Neoplasia | Obligate PD |
Gastrointestinal tract | Acanthosis nigricans maligna Necrolytic migratory erythema Leser–Trelat’s syndrome Trousseau’s syndrome |
Myeloproliferative and lymphoproliferative disorders | Paraneoplastic pemphigus |
Miscellaneous | Acquired hypertricosis lanuginose Acrokeratosis paraneoplastica of Bazex Erythema gyratum repens |
Neoplasia | Facultative PD |
Low respiratory tract and gastrointestinal tract | Paraneoplastic dermatomyositis |
Esophageal tract | Acquired palmo-plantar keratoderma |
Myeloproliferative and lymphoproliferative disorders | Sweet syndrome Pyoderma ganrenosum |
Miscellaneous | Pytiriasis rotunda Multicentric reticulohistiocytosis Anti-laminina 332 bullous pemphigoid |
Criterion | Details |
---|---|
Clinical features | Painful mucosal erosions with or without a multiform skin eruption characterized by blisters and erosions, occurring in association with an occult or evident neoplasm |
Pathology | Suprabasal intraepithelial acantholysis, interface dermatitis, and necrosis of keratinocytes |
Direct immunofluorescence | Combined presence of IgG and complement granular-linear deposition within the epidermal intercellular spaces and along the basement-membrane zone |
Indirect immunofluorescence | Presence of circulating antibodies directed against the intercellular zone of stratified squamous or transitional epithelia |
Immunoprecipitation | Complex of proteins, including desmoplakin 1 (250 kDa), bullous pemphigoid antigen (230 kDa), envoplakin (210 kDa), desmoplakin 2 (210 kDa), periplakin (190 kDa) and α-2-macroglobulin-like-1 (170 kDa) |
Criterion | Details |
---|---|
1. Symmetric proximal muscle weakness | Dysphagia and/or diaphragmatic weakness can be present |
2. Increase of skeletal muscle enzymes | High level of skeletal muscle enzymes, such as creatine kinase, aspartate transaminase, alanine transaminase, andlactate dehydrogenase |
3. Alteration at EMG | Several abnormalities can be detected, including positive sharp waves, and repetitive high-frequency discharges |
4. Alterations showed in muscle biopsy | Several pattern can be showed, including loss of capillaries, deposits of C5b–C9 on the capillaries, and endothelial microtubular inclusions |
5. Typical skin rash | Heliotrope rash or Gottron’s sign |
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Didona, D.; Fania, L.; Didona, B.; Eming, R.; Hertl, M.; Di Zenzo, G. Paraneoplastic Dermatoses: A Brief General Review and an Extensive Analysis of Paraneoplastic Pemphigus and Paraneoplastic Dermatomyositis. Int. J. Mol. Sci. 2020, 21, 2178. https://doi.org/10.3390/ijms21062178
Didona D, Fania L, Didona B, Eming R, Hertl M, Di Zenzo G. Paraneoplastic Dermatoses: A Brief General Review and an Extensive Analysis of Paraneoplastic Pemphigus and Paraneoplastic Dermatomyositis. International Journal of Molecular Sciences. 2020; 21(6):2178. https://doi.org/10.3390/ijms21062178
Chicago/Turabian StyleDidona, Dario, Luca Fania, Biagio Didona, Rüdiger Eming, Michael Hertl, and Giovanni Di Zenzo. 2020. "Paraneoplastic Dermatoses: A Brief General Review and an Extensive Analysis of Paraneoplastic Pemphigus and Paraneoplastic Dermatomyositis" International Journal of Molecular Sciences 21, no. 6: 2178. https://doi.org/10.3390/ijms21062178
APA StyleDidona, D., Fania, L., Didona, B., Eming, R., Hertl, M., & Di Zenzo, G. (2020). Paraneoplastic Dermatoses: A Brief General Review and an Extensive Analysis of Paraneoplastic Pemphigus and Paraneoplastic Dermatomyositis. International Journal of Molecular Sciences, 21(6), 2178. https://doi.org/10.3390/ijms21062178