Dermatosis as The Initial Presentation of Gastric Cancer：Report of Two Cases and Review of The Literatures_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GE Wei , TENG Buwei , YU Decai ,  CHEN Gang , ZHENG Liming , DING Yitao

Department of General Gurgery， Drum Tower Clinical Medical College of Nanjing Medical University， Nanjing 210008， Jiangsu Province， China;

Corresponding author：

CHEN Gang, Email: gulou_hospital@yahoo.com.cn

Keywords：

Paraneoplastic dermatoses; Erythroderma; Dermatomyositis; Malignant tumor

Video：

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Objective 　To improve the vigilance and awareness of malignancy presenting as dermatosis and reduce misdiagnosis.
Methods 　Two cases of gastric cancer presenting as dermatomyositis and erythroderma respectively in the last two years were retrospectively analyzed and the relevant literatures were reviewed.
Results 　The two patients were admitted to hospital due to skin diseases， diagnosis of gastric cancer through endoscopy， and proved to be gastric cancer associated with dermatosis by pathological examination after surgical resection.
Conclusions 　Paraneoplastic dermatoses can be seen as an early manifestation of the internal malignancy. The patients with paraneoplastic dermatoses should be excluded visceral tumors by the means of biomarkers， endoscopy， PET/CT， and so on.

Citation： GE Wei,TENG Buwei,YU Decai,CHEN Gang,ZHENG Liming,DING Yitao. Dermatosis as The Initial Presentation of Gastric Cancer：Report of Two Cases and Review of The Literatures. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(10): 1127-1131. doi: Copy

1.	Schimrigch K， Blaes F. Paraneoplastic syndromes[J]. Zh NevrolPsikhiatr Im S S Korsakova， 2002， 102(11)：48-49.
2.	Brenner S， Tamir E， Maharshak N， et al. Cutaneous manifestations of internal malignancies[J]. Clin Dermatol， 2001， 19(3)：290-297.
3.	Ofuji S， Furakawa F， Miyachi Y， et al. Papuloerythroderma[J]. Dermatologica， 1984， 169(3)： 125-130.
4.	Sugita K， Koga C， Yoshiki R， et al. Papuloerythroderma caused by aspirin[J]. Arch Dermatol， 2006， 142(6)：792-793.
5.	Sugita K， Kabashima K， Nakashima D， et al. Papuloerythroderma of Ofuji induced by furosemid[J]. J Am Acad Dermatol， 2008， 58 (2 Suppl)：S54-S55.
6.	De Vries HJ， Koopmans AK， Starink TM， et al. Ofuji papuloerythroderma associated with Hodgkin’s lymphoma[J]. Br J Dermatol， 2002， 147(1)： 186-187.
7.	Martinez-Barranca MI， Muñoz-Pérez MA， García-Morales I， et al. Ofuji papuloerythroderma evolving to cutaneus T-cell lymphoma[J]. J Eur Acad Dermatol Venereol， 2005， 19(1)： 104-106.
8.	Pereiro M Jr， Sánchez-Aguilar D， Pereiro Ferreirós MM， et al. Cutaneous T-cell lymphoma：an expression of papuloerythrodermaof Ofuji[J]. J Eur Acad Dermatol Venereol， 2003， 17(2)： 240-241.
9.	Shimauchi T， Sugita K， Nakamura M， et al. Leukaemic cutaneousT-cell lymphoma-manifesting papuloerythroderma with CD3― CD4＋phenotype[J]. Acta Derm Venereol， 2010， 90(1)： 68-72.
10.	Guisado Vasco P， Fraile Rodríguez G， Barbolla Diaz I， et al. Comments on：papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol， 2010， 20(3)： 418.
11.	Salgüero I， Moreno C， Aguayo-Leiva I， et al. Papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol， 2009， 19(4)： 396-397.
12.	Wong CL， Houghton JB， Andrew S， et al. Papuloerythroderma of Ofuji associated with acute myeloid leukaemia[J]. Clin Exp Dermatol， 2003， 28(3)： 277-279.
13.	Hur J， Seong JY， Choi TS， et al. Mycosis fungoides presentingas Ofuji’s papuloerythroderma[J]. J Eur Acad Dermatol Venereol，.
14.	Shimauchi T， Ohshima A， Tokura Y. Folliculotropic mycosis fungoides presenting as papuloerythroderma[J]. J Dermatol， 2006， 33(7)： 498-500.
15.	Kim SW， Kang YS， Park SH， et al. A case of erythrodermicdermatomyositis associated with gastric cancer[J]. Ann Dermatol，.
16.	Lonnee ER， Toonstra J， van der Putte SC， et al. Papuloerythroderma of Ofuji in a HIV-infected patient[J]. Br J Dermatol， 1996， 135(3)： 500-501.
17.	García-Patos V， Repiso T， Rodríguez-Cano L， et al. Ofuji papuloerythroderma in a patient with the acquired immunodeficiency syndrome[J]. Dermatology， 1996， 192(2)： 164-166.
18.	Pectasides D， Koumpou M， Gaglia A， et al. Dermatomyositisassociated with breast cancer[J]. Anticancer Res， 2006， 26(3B)：.
19.	Celebi S， Gul A， Kamali S， et al. Amyopathic dermatomyositis associated with cervical cancer[J]. Clin Rheumatol， 2001， 20(6)：.
20.	Chao LW， Wei LH. Dermatomyositis as the initial presentation of ovarian cancer[J]. Taiwan J Obstet Gynecol， 2009， 48(2)：178-180.
21.	Scheinfeld NS. Ulcerative paraneoplastic dermatomyositis secon-dary to metastatic breast cancer[J]. Skinmed， 2006， 5(2)：94-96.
22.	Nakamura S， Umeda T， Yokozeki H， et al. Possible involvement of tumour-derived interleukin-6 in dermatomyositis associated with cervical squamous cell carcinoma[J]. Br J Dermatol， 1997， 136(3)：475-476.
23.	Valverde R， Sanchez-Caminero MP， Calzado L， et al. Dermatomyositis and punctate porokeratotic keratoderma as paraneoplastic syndrome of ovarian carcinoma[J]. Actas Dermosifiliogr， 2007， 98(5)：358-360.
24.	Dhungel S， Chalise SN， Kandel S， et al. Dysphagia as a presentingsymptom in a case of dermatomyositis and occult gastric malignancy[J]. Nepal Med Coll J， 2005， 7(1)：77-78.
25.	Castro C， Khan Y， Awasum M， et al. Case report：primary gastricmelanoma in a patient with dermatomyositis[J]. Am J Med Sci， 2008， 336(3)：282-284.
26.	Przybylski G， Jarzemska A， Czerniak J， et al. A case report of a patient with dermatomyositis as a prodromal sign of lung cancer[J]. Pol Arch Med Wewn， 2008， 118(3)：143-147.
27.	Park JK， Subhawong AP， Ziminski CM， et al. Dermatomyositis as the initial presentation of a large anaplastic T-cell lymphoma[J]. J Clin Oncol， 2011， 29(13)：e378- e380.
28.	Shrivastav A， Kumar V， Pal J. Dermatomyositis associated with acute myelocytic leukemia[J]. Rheumatol Int， 2010， 30(5)：671-673.
29.	Mooney CJ， Dunphy EJ， Stone B， et al. Identification of autoan-tibodies elicited in a patient with prostate cancer presenting asdermatomyositis[J]. Int J Urol， 2006， 13(3)：211-217.
30.	Hassoun N， Agabrya A， Levy Y. Mediastinal cancer presenting as dermatomyositis—a case report[J]. Harefuah， 2011， 150(7)：574-577， 617， 618.
31.	Kee SJ， Kim TJ， Lee SJ， et al. Dermatomyositis associated with hepatitis B virus-related hepatocellular carcinoma[J]. RheumatolInt， 2009， 29(5)：595-599.
32.	Shinohara N， Harabayashi T， Suzuki S， et al. Advanced renal pelvic carcinoma associated with dermatomyositis[J]. Int J Urol， 2005， 12(10)：906-908.
33.	Farthing CF， Staughton RC， Harper JI， et al. Papuloerythroderma：a further case with the “deck chair sign”[J]. Dermatologica， 1986， 172(1)： 65-66.
34.	Bech-Thomsen N， Thomsen K. Ofuji’s papuloerythroderma：a study of 17 cases[J]. Clin Exp Dermatol， 1998， 23(2)： 79-83.
35.	Sunami K， Taniguchi H， Moriyama T， et al. Papuloerythrodermaassociated with gastric cancer；report of a case[J]. Nippon Shokakibyo Gakkai Zasshi， 1995， 92(9)： 1285-1288.
36.	Watanabe M， Kimura T， Murasawa A. A case report of apatient with papuloerythroderma (Ofuji) and gastric cancer[J]. Jpn J Clin Dermatol， 2002， 56： 445-447.
37.	Nazzari G， Sabbatini C. Ofuji’s papuloerythroderma. An association with early gastric cancer[J]. Eur J Dermatol， 1999， 9(4)：317-318.
38.	Nomura T， Kodama K， Moriuchi R， et al. Papuloerythroderma of Ofuji associated with early gastric cancer[J]. Int J Dermatol， 2008， 47(6)： 590-591.
39.	Schepers C， Malvehy J， Azon-Masoliver A， et al. Papuloerythroderma of Ofuji： a report of 2 cases including the first European case associated with visceral carcinoma[J]. Dermatology， 1996， 193(2)：131-135.
40.	Chong VH， Lim CC. Erythroderma as the first manifestation of colon cancer[J]. South Med J， 2009， 102(3)： 334-335.
41.	Nishijima S. Papuloerythroderma associated with hepatocellular carcinoma[J]. Br J Dermatol， 1998， 139(6)： 1115-1116.
42.	Kameyama H， Shirai Y， Date K， et al. Gallbladder carcinoma presenting as exfoliative dermatitis (erythroderma)[J]. Int J Gastrointest Cancer， 2005， 35(2)： 153-155.
43.	Akioka J， Moriwaki SI， Yagi H， et al. A case of papuloerythroderma：an association with early cancer[J]. Acta Dermatol， 1988， 83： 181-184.
44.	Raffel GD， Gravallese EM， Schwab P， et al. Diagnostic dilemmasin oncology： case 2. Dermatomyositis and ovarian cancer[J]. J Clin Oncol， 2001， 19(23)：4341-4343.
45.	Callen JP. The value of malignancy evaluation in patients with dermatomyositis[J]. J Am Acad Dermatol， 1982， 6(2)：253-259.
46.	Callen JP. Dermatomyositis and female malignancy[J]. J Surg Oncol， 1986， 32(2)：121-124.
47.	-440.
48.	， 16(4)：393-396.
49.	， 21(4)： 435-439.
50.	-2331.

1. Schimrigch K， Blaes F. Paraneoplastic syndromes[J]. Zh NevrolPsikhiatr Im S S Korsakova， 2002， 102(11)：48-49.
2. Brenner S， Tamir E， Maharshak N， et al. Cutaneous manifestations of internal malignancies[J]. Clin Dermatol， 2001， 19(3)：290-297.
3. Ofuji S， Furakawa F， Miyachi Y， et al. Papuloerythroderma[J]. Dermatologica， 1984， 169(3)： 125-130.
4. Sugita K， Koga C， Yoshiki R， et al. Papuloerythroderma caused by aspirin[J]. Arch Dermatol， 2006， 142(6)：792-793.
5. Sugita K， Kabashima K， Nakashima D， et al. Papuloerythroderma of Ofuji induced by furosemid[J]. J Am Acad Dermatol， 2008， 58 (2 Suppl)：S54-S55.
6. De Vries HJ， Koopmans AK， Starink TM， et al. Ofuji papuloerythroderma associated with Hodgkin’s lymphoma[J]. Br J Dermatol， 2002， 147(1)： 186-187.
7. Martinez-Barranca MI， Muñoz-Pérez MA， García-Morales I， et al. Ofuji papuloerythroderma evolving to cutaneus T-cell lymphoma[J]. J Eur Acad Dermatol Venereol， 2005， 19(1)： 104-106.
8. Pereiro M Jr， Sánchez-Aguilar D， Pereiro Ferreirós MM， et al. Cutaneous T-cell lymphoma：an expression of papuloerythrodermaof Ofuji[J]. J Eur Acad Dermatol Venereol， 2003， 17(2)： 240-241.
9. Shimauchi T， Sugita K， Nakamura M， et al. Leukaemic cutaneousT-cell lymphoma-manifesting papuloerythroderma with CD3― CD4＋phenotype[J]. Acta Derm Venereol， 2010， 90(1)： 68-72.
10. Guisado Vasco P， Fraile Rodríguez G， Barbolla Diaz I， et al. Comments on：papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol， 2010， 20(3)： 418.
11. Salgüero I， Moreno C， Aguayo-Leiva I， et al. Papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol， 2009， 19(4)： 396-397.
12. Wong CL， Houghton JB， Andrew S， et al. Papuloerythroderma of Ofuji associated with acute myeloid leukaemia[J]. Clin Exp Dermatol， 2003， 28(3)： 277-279.
13. Hur J， Seong JY， Choi TS， et al. Mycosis fungoides presentingas Ofuji’s papuloerythroderma[J]. J Eur Acad Dermatol Venereol，.
14. Shimauchi T， Ohshima A， Tokura Y. Folliculotropic mycosis fungoides presenting as papuloerythroderma[J]. J Dermatol， 2006， 33(7)： 498-500.
15. Kim SW， Kang YS， Park SH， et al. A case of erythrodermicdermatomyositis associated with gastric cancer[J]. Ann Dermatol，.
16. Lonnee ER， Toonstra J， van der Putte SC， et al. Papuloerythroderma of Ofuji in a HIV-infected patient[J]. Br J Dermatol， 1996， 135(3)： 500-501.
17. García-Patos V， Repiso T， Rodríguez-Cano L， et al. Ofuji papuloerythroderma in a patient with the acquired immunodeficiency syndrome[J]. Dermatology， 1996， 192(2)： 164-166.
18. Pectasides D， Koumpou M， Gaglia A， et al. Dermatomyositisassociated with breast cancer[J]. Anticancer Res， 2006， 26(3B)：.
19. Celebi S， Gul A， Kamali S， et al. Amyopathic dermatomyositis associated with cervical cancer[J]. Clin Rheumatol， 2001， 20(6)：.
20. Chao LW， Wei LH. Dermatomyositis as the initial presentation of ovarian cancer[J]. Taiwan J Obstet Gynecol， 2009， 48(2)：178-180.
21. Scheinfeld NS. Ulcerative paraneoplastic dermatomyositis secon-dary to metastatic breast cancer[J]. Skinmed， 2006， 5(2)：94-96.
22. Nakamura S， Umeda T， Yokozeki H， et al. Possible involvement of tumour-derived interleukin-6 in dermatomyositis associated with cervical squamous cell carcinoma[J]. Br J Dermatol， 1997， 136(3)：475-476.
23. Valverde R， Sanchez-Caminero MP， Calzado L， et al. Dermatomyositis and punctate porokeratotic keratoderma as paraneoplastic syndrome of ovarian carcinoma[J]. Actas Dermosifiliogr， 2007， 98(5)：358-360.
24. Dhungel S， Chalise SN， Kandel S， et al. Dysphagia as a presentingsymptom in a case of dermatomyositis and occult gastric malignancy[J]. Nepal Med Coll J， 2005， 7(1)：77-78.
25. Castro C， Khan Y， Awasum M， et al. Case report：primary gastricmelanoma in a patient with dermatomyositis[J]. Am J Med Sci， 2008， 336(3)：282-284.
26. Przybylski G， Jarzemska A， Czerniak J， et al. A case report of a patient with dermatomyositis as a prodromal sign of lung cancer[J]. Pol Arch Med Wewn， 2008， 118(3)：143-147.
27. Park JK， Subhawong AP， Ziminski CM， et al. Dermatomyositis as the initial presentation of a large anaplastic T-cell lymphoma[J]. J Clin Oncol， 2011， 29(13)：e378- e380.
28. Shrivastav A， Kumar V， Pal J. Dermatomyositis associated with acute myelocytic leukemia[J]. Rheumatol Int， 2010， 30(5)：671-673.
29. Mooney CJ， Dunphy EJ， Stone B， et al. Identification of autoan-tibodies elicited in a patient with prostate cancer presenting asdermatomyositis[J]. Int J Urol， 2006， 13(3)：211-217.
30. Hassoun N， Agabrya A， Levy Y. Mediastinal cancer presenting as dermatomyositis—a case report[J]. Harefuah， 2011， 150(7)：574-577， 617， 618.
31. Kee SJ， Kim TJ， Lee SJ， et al. Dermatomyositis associated with hepatitis B virus-related hepatocellular carcinoma[J]. RheumatolInt， 2009， 29(5)：595-599.
32. Shinohara N， Harabayashi T， Suzuki S， et al. Advanced renal pelvic carcinoma associated with dermatomyositis[J]. Int J Urol， 2005， 12(10)：906-908.
33. Farthing CF， Staughton RC， Harper JI， et al. Papuloerythroderma：a further case with the “deck chair sign”[J]. Dermatologica， 1986， 172(1)： 65-66.
34. Bech-Thomsen N， Thomsen K. Ofuji’s papuloerythroderma：a study of 17 cases[J]. Clin Exp Dermatol， 1998， 23(2)： 79-83.
35. Sunami K， Taniguchi H， Moriyama T， et al. Papuloerythrodermaassociated with gastric cancer；report of a case[J]. Nippon Shokakibyo Gakkai Zasshi， 1995， 92(9)： 1285-1288.
36. Watanabe M， Kimura T， Murasawa A. A case report of apatient with papuloerythroderma (Ofuji) and gastric cancer[J]. Jpn J Clin Dermatol， 2002， 56： 445-447.
37. Nazzari G， Sabbatini C. Ofuji’s papuloerythroderma. An association with early gastric cancer[J]. Eur J Dermatol， 1999， 9(4)：317-318.
38. Nomura T， Kodama K， Moriuchi R， et al. Papuloerythroderma of Ofuji associated with early gastric cancer[J]. Int J Dermatol， 2008， 47(6)： 590-591.
39. Schepers C， Malvehy J， Azon-Masoliver A， et al. Papuloerythroderma of Ofuji： a report of 2 cases including the first European case associated with visceral carcinoma[J]. Dermatology， 1996， 193(2)：131-135.
40. Chong VH， Lim CC. Erythroderma as the first manifestation of colon cancer[J]. South Med J， 2009， 102(3)： 334-335.
41. Nishijima S. Papuloerythroderma associated with hepatocellular carcinoma[J]. Br J Dermatol， 1998， 139(6)： 1115-1116.
42. Kameyama H， Shirai Y， Date K， et al. Gallbladder carcinoma presenting as exfoliative dermatitis (erythroderma)[J]. Int J Gastrointest Cancer， 2005， 35(2)： 153-155.
43. Akioka J， Moriwaki SI， Yagi H， et al. A case of papuloerythroderma：an association with early cancer[J]. Acta Dermatol， 1988， 83： 181-184.
44. Raffel GD， Gravallese EM， Schwab P， et al. Diagnostic dilemmasin oncology： case 2. Dermatomyositis and ovarian cancer[J]. J Clin Oncol， 2001， 19(23)：4341-4343.
45. Callen JP. The value of malignancy evaluation in patients with dermatomyositis[J]. J Am Acad Dermatol， 1982， 6(2)：253-259.
46. Callen JP. Dermatomyositis and female malignancy[J]. J Surg Oncol， 1986， 32(2)：121-124.
47. -440.
48. ， 16(4)：393-396.
49. ， 21(4)： 435-439.
50. -2331.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Dermatosis as The Initial Presentation of Gastric Cancer：Report of Two Cases and Review of The Literatures

Abstract Full text Figures/Tables Video References Cited by

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