Akademik Veri Yönetim Sistemi
TURKDERM-TURKISH ARCHIVES OF DERMATOLOGY AND VENEROLOGY, cilt.47, ss.65-68, 2013 (SCI-Expanded)
Pruritus and erythroderma could be a presenting sign of numerous internal malignancies. These symptomes can occur in the early stages of internal malignancies or precede them by months. On the other hand, these symptoms can also be caused by various other common conditions; therefore they are not specific for paraneoplastic diseases. This review overviews the current state of knowledge regarding paraneoplastic pruritus and paraneoplastic erythroderma, and highlights the association between these conditions and internal malignancies together with their epidemiological, clinical and diagnostic features. Paraneoplastic pruritus is often generalized with intractable and chronic course. Nocturnal pruritus can be a significant problem for these patients. Patients may present with secondary skin changes including excoriations, hyperpigmentation, lichenification and prurigo nodules. Paraneoplastic pruritus is more commonly known to be in association with Hodgkin lymphoma and other lymphomas, leukemia and polycythemia vera. Paraneoplastic erythroderma is more agressive and resistant to standart treatment modalities. Weakness, and significant weight loss are frequently seen as additional findings. It can be associated with fine scaling and hyperpigmentation (melanoerythroderma). Papuloerythroderma of Ofuji is distinct and rare clinical entity presenting with erythroderma. It is characterized by intensely pruritic and widespread red flat-topped papules. Cutaneous T-cell lymphoma, especially its leukemic variant Sezary syndrome are the most common cause of paraneoplastic erythroderma. A detailed and meticulous medical history, dermatologic and physical examination including an exam for lymph nodes should be the first step in the evaluation of paraneoplastic pruritus and erythroderma. Subsequent diagnostic testing must be directed in the light of clinical findings, and especially lymphoproliferative diseases should be carefully evaluated. Such a review should be repeated at follow-up visits if the first evaluation is found to be normal limits.