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ICD-9 : 199.0 • ICD-10 : M8000/6

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  • Mucocutaneous findings may suggest systemic cancers in several ways:
  • Associations of heritable mucocutaneous disorders with systemic cancers.
  • By action at a distance, i.e., paraneoplastic syndromes.
  • Or spread of cancer to skin or mucosal sites by direct, lymphatic, or hematogenous extension (cutaneous metastasis).

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Classification of Skin Signs of Systemic Cancer1

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Metastatic Cancers

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  • Persistent tumor. Lymphatic extension, hematogenous spread
  • Direct extension. Paget disease, extramammary Paget disease
  • Lymphomas with secondary skin involvement (Section 20)

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Heritable Disorders

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Paraneoplastic Syndromes

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  • Acanthosis nigricans, malignant, tripe palms
  • Acquired ichthyosis
  • Bazex syndrome
  • Carcinoid syndrome
  • Dermatomyositis (Dermatomyositis)
  • Ectopic ACTH syndrome
  • Erythema gyratum repens
  • Gardner syndrome
  • Glucagonoma syndrome
  • Hypertrichosis lanuginosa
  • Muir-Torre syndrome
  • Palmar keratoses
  • Paraneoplastic pemphigus
  • Pruritus (Section 36)
  • Pyoderma gangrenosum (Pyoderma Gangrenosum)
  • Sweet syndrome (Sweet Syndrome)
  • Vasculitis (Vasculitis)

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1Conditions covered in this section are printed in bold, conditions dealt with in other sections are in italics. Rare conditions not discussed in this book are described in CA deWitt et al, in K Wolff et al (eds): Fitzpatrick's Dermatology in General Medicine 7th ed. New York, McGraw-Hill, 2008, pp 1493–1507.

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ICD-9 : 199.0 • ICD-10 : M8000/6

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  • Metastatic cancer to the skin is characterized by solitary or multiple dermal or subcutaneous nodules, occurring as metastatic cells from a distant noncontiguous primary malignant neoplasm.
  • They are transported to and deposited in the skin or subcutaneous tissue by one of the following routes:

    • Lymphatic routes.
    • Hematogeneous spread.
    • Contiguous spread across the peritoneal cavity or other tissues.
  • For metastasis nonmelanoma skin cancers and melanoma, see Sections 11 and 12.

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Epidemiology

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Age of Onset

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Any age, but usually older.

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Sex

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Frequency of primary tumors varies with sex.

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Incidence

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In principle almost any cancer can metastasize to skin. Skin metastases occur in up to 10% of all patients with cancer. The frequency of metastases according to type of tumor are shown in Table 18-1.

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Table Graphic Jump Location
Table 18-1 Percent of Patients with Cutaneous Metastases
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Pathogenesis

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Includes detachment of cancer cells from primary tumor, invasion, intravasation ...

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