Cutaneous Paraneoplastic Manifestations of Hematological Malignancies

Abstract

The skin, as the largest organ of the human body, can have
a key role in the early diagnosis of systemic diseases. Cutaneous
manifestations can be the initial symptom of certain
malignant hematological diseases (Hodgkin lymphoma,
chronic lymphocytic leukemia, acute myeloid leukemia).
These can be classified as specific when caused by direct
invasion of malignant cells in the skin or by loco-regional expansion
of the tumoral disease or unspecific when caused
by the altered regulation of the immune system typical of
oncologic patients (characterized by absence of neoplastic
cells in the skin). The unspecific injuries are more frequent,
have polymorphous appearance and may precede, follow
or have a parallel course with the underlying malignancy. In
this article, the most frequent cutaneous diseases associated
with hematological malignancies are reviewed, namely
neutrophilic dermatoses (Sweet syndrome and pyoderma
gangrenosum), connective tissue diseases (dermatomyositis),
pruritus of unknown origin and vesiculobullous disorders
(pemphigus vulgaris and paraneoplastic pemphigus).
Although less common, other diseases are also associated
with malignancy such as amyloidosis, reactive erythemas,
vascular dermatoses (livedo reticularis, erythromelalgia and
vasculitis) and other disorders (acanthosis nigricans, sign of
Leser-Trélat and acquired ichthyosis). The main purpose of
this review is to highlight the relevance of cutaneous manifestations
that can be the first symptom of hematological malignancies
and lead to differential diagnosis.