Abstract
Skin can show various manifestations in patients suffering with malignancy, which may be specific or non specific. In absence of any available literature on this issue, we conducted this study to know the dermatological conditions affecting Nepalese patients with malignancy. A total of 62 patients who were referred for dermatological consultation both from out-patient department and in-patient department of Nepal Cancer Hospital were included in this study. Data including demographic variables, type of malignancy, duration since diagnosis, chemotherapeutic agents administered and dermatological manifestation were recorded. The frequency of Dermatological manifestation in cancer patients was found to be 0.41%. There were 56% females and 44% males. Mean age of presentation was 44 years. These patients had primary malignancy as carcinoma breast in 31%, lung carcinoma 21%, carcinoma colon 16%, carcinoma rectum 8%, carcinoma pancreas 7% and 3% each had carcinoma prostate, carcinoma stomach, carcinoma ovary and oral carcinoma and Ewing sarcoma. The mean duration of presentation of primary carcinoma was 8 months. The most frequent dermatoses was eczema in 39%, followed by infection 25%, pruritus 14%, insect bite hypersensitivity 3.2%, disorder of pilosebaceous unit 3.2%, urticaria 3.2%, pigmentary changes 3.2%, nail involvement 3.2%, drug rash 2%, vesiculo-blistering disorder 2% and cutaneous metastasis in 2%. In absence of screening program, we found a very low frequency of cutaneous manifestation in patients with malignancy in our study. We recommend a prospective long term follow-up study with institution of screening and awareness program.
Highlights
Skin is a mirror of functioning of internal organs
Cutaneous manifestations may be highly specific to the disease, occur primarily due to the malignancy and include cutaneous metastases and cutaneous markers of various tumor syndromes or are nonspecific and include paraneoplastic syndromes, cutaneous infections, pigmentary disturbances, etc.[3]
Some changes are due to the various treatment modalities employed; for example, alopecia, papulopustular rash, hand-foot syndrome, paronychia and mucositis are common skin reactions seen in patients undergoing chemotherapy
Summary
Skin changes can either be the first sign of a deeper problem including an internal malignancy. Dermatological manifestation in cancer patients can be direct tumor spread from adjacent or deeper tissue or cutaneous metastasis from the internal organ, side effects of the chemotherapeutic agents or opportunistic infections. The two major criteria, including both conditions begin almost at the same time and both conditions follow a parallel course are sufficient to consider a dermatosis as paraneoplastic. This phenomenon is the result of interaction between the tumor and mediators like hormones, cytokines ,antibodies, growth factors and the involved tissue.1Dermatological manifestations in cancer patient is broadly divided as specific or nonspecific changes.[2]. This study was conducted to know the clinical spectrum of dermatological manifestations in cancer patients
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