Cutaneous Signs and Syndromes Associated With Internal Malignancies

Claudia C. Ramirez, MD; Brian Berman, MD, PhD


Skinmed. 2005;4(2):84-92. 

In This Article

Ichthyosis Acquisita and Metastases From Visceral Tumors

Ichthyosis aquisita, or acquired ichthyosis, is characterized by rhomboidal scales that are lifted off the skin surface. It has to be distinguished from xerosis, which frequently responds to lubricating creams.[23] Although the use of some medications and some benign conditions may be related to acquired ichthyosis (including hypothyroidism, sarcoidosis, malnutrition), the new onset of ichthyosis in adult life is often related to an underlying malignancy.[23] Hodgkin disease was found in about 70% of patients with acquired ichthyosis and internal neoplasia.[24] Acquired ichthyosis has also been related to reticulolymphosarcoma; T-cell lymphoma; multiple myeloma; and lung, breast, and cervical cancers.

Carcinomas originating in the breasts, lungs, oral cavity, colon/rectum, ovary, larynx, stomach, urinary bladder, and kidneys have the highest proclivity to metastasize to the skin. One group of authors[25] reported a frequency of 5% for cutaneous metastasis in 7316 patients with carcinoma, and in 0.8% the skin metastasis was the first sign of the internal malignancy. Skin metastases often present as erythematous, painless, and rapidly growing solitary or multiple cutaneous or subcutaneous nodules. Usually the location correlates with the underlying carcinoma; such as breast cancers most commonly metastasize to the anterior chest wall.