Cutaneous manifestations of gastrointestinal disease

Shah, Kejal R.; Boland, C. Richard; Patel, Mahir; Thrash, Breck; Menter, Alan

doi:10.1016/j.jaad.2012.10.037

Cited by 127 publications

(103 citation statements)

References 134 publications

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“…En los tumores GI, actúan como marcadores de dichos tumores y, en muchos casos, permiten detectar oportunamente esas neoplasias (14). Para configurar el síndrome, se deben cumplir los criterios de Curth: ausencia de infiltración directa de células malignas, inicio simultáneo y curso paralelo con el tumor y exclusión de síndromes genéticos (13,15). Las alteraciones dermatológicas más importantes son las siguientes:…”

Section: Síndromes Paraneoplásicos Dermatológicosunclassified

“…Consiste en la aparición de placas aterciopeladas con zonas hiperpigmentadas de relieve, simétricas, localizadas en sitios intertriginosos, como axilas, cuello y región anogenital, submamaria o mamilar (14,15,16) (Figura 2). En algunos casos, se presentan proyecciones cutáneas pediculadas, llamadas acrocordones, y lesiones papilomatosas hipopigmentadas en las mucosas (17).…”

Section: Acantosis Nigricans (An)unclassified

“…En algunos casos, se presentan proyecciones cutáneas pediculadas, llamadas acrocordones, y lesiones papilomatosas hipopigmentadas en las mucosas (17). En el 35% al 50% de los casos, se encuentra compromiso de la mucosa oral (1, 18), aunque también puede comprometer otras mucosas (14,15) y, en el 41% de los casos, se asocia con prurito (19).…”

Section: Acantosis Nigricans (An)unclassified

“…La forma maligna corresponde al 20% de los casos (20) y se presenta en 2 de cada 12 000 pacientes con cáncer (21). A diferencia de la forma benigna, aparece generalmente en mayores de 40 años (13), sin asociación familiar (17), se inicia de manera espontánea, es extensa y progresa rápidamente (14,15). Además, sigue un curso paralelo y es un indicador de recurrencia (17).…”

Section: Acantosis Nigricans (An)unclassified

“…Por lo anterior, la detección de esta lesión amerita una profunda investigación, y más aún en pacientes mayores de 40 años con otro signo paraneoplásico, como la palma de intestino (Figura 3) y el signo de Leser-Trélat (Figura 4), sin una patología benigna que la pueda explicar, como la obesidad y otras endocrinopatías (13,14,16,22). La acantosis nigricans, la queratodermia palmoplantarconocida también como "palmas de terciopelo o intestino" (tripe palms) y el signo de Leser-Trélat se han relacionado frecuentemente y, aunque su etiología se desconoce, se considera que tienen el mismo mecanismo fisiopatológico, como es la producción de factores de crecimiento por parte del tumor que interactúan con el factor de crecimiento epidér-mico (EGF) o su receptor (13,14,15,22). La palma de intestino consiste en un engrosamiento epidérmico rugoso en las palmas, con dermatoglifos prominentes (paquidermatoglifia) (15).…”

Section: Acantosis Nigricans (An)unclassified

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Síndromes paraneoplásicos en tumores gastrointestinales. Revisión de tema

Paez

Regino

et al. 2017

Rev. Colomb. Gastroenterol.

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ResumenLos síndromes paraneoplásicos representan manifestaciones clínicas que producen los tumores en sitios distantes a ellos y que no están relacionadas físicamente con ellos ni con sus metástasis. Diferentes tumores gastrointestinales pueden presentar síndromes o manifestaciones sistémicas, dermatológicas, hematológi-cas, renales y neurológicas, entre otras. Aquí se ofrece una revisión de esas distintas manifestaciones. Palabras claveSíndrome paraneoplásico, gastrointestinal, tumores. AbstractParaneoplastic syndromes produce tumors at sites distant from themselves and are not physically related to those tumors or to their metastases. Various gastrointestinal tumors may present syndromes or systemic, dermatological, hematological, renal, neurological and other manifestations. This study reviews these manifestations. KeywordsParaneoplastic syndrome, gastrointestinal, tumors.Revisión de tema DOI: https://doi.org/10.22516/25007440.155 INTRODUCCIÓNLos síndromes paraneoplásicos (SPN) son un grupo heterogéneo de manifestaciones clínicas que se producen cuando un tumor provoca un daño en un órgano o sistema distante y que no están relacionadas físicamente con el tumor o sus metástasis (1). Esas alteraciones son independientes del efecto local del tumor, la invasión a otros órga-nos, los déficits nutricionales y las consecuencias derivadas del tratamiento antineoplásico (1, 2). La gran variedad de manifestaciones clínicas es secundaria a la liberación de sustancias por parte de las células neoplásicas malignas (2) que liberan hormonas, péptidos similares a hormonas, factores de crecimiento y citoquinas (1, 2, 3). Adicionalmente, también participan respuestas inmunitarias que, inicialmente, estaban dirigidas contra las nuevas sustancias o antígenos tumorales (oncoantígenos) y que, por reacción cruzada, terminan lesionando tejidos normales (3, 4) y, finalmente, acumulando complejos inmunes (5). Los diferentes SPN se dividen según el órgano o sistema al que afecten y, clásicamente, se clasifican en endocrinometabólicos, dermatológicos, hematológicos, reumatológicos y neurológicos (3). En la presente revisión, se describen los SPN producidos por tumores gastrointestinales (GI).

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Section: Síndromes Paraneoplásicos Dermatológicosunclassified

Section: Acantosis Nigricans (An)unclassified

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Síndromes paraneoplásicos en tumores gastrointestinales. Revisión de tema

Paez

Regino

et al. 2017

Rev. Colomb. Gastroenterol.

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Association of Psoriasis With Inflammatory Bowel Disease

2018

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IMPORTANCE Patients with psoriasis may experience comorbidities involving cardiovascular diseases, chronic kidney disease, uveitis, psychiatric disturbances, and metabolic syndrome. However, the association between psoriasis and inflammatory bowel disease (IBD) has been largely unclear. OBJECTIVE To investigate the association of psoriasis with IBD. DATA SOURCES For this systematic review and meta-analysis, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant studies from inception to January 17, 2018. STUDY SELECTION Case-control, cross-sectional, or cohort studies that examined either the odds or risk of IBD in patients with psoriasis were included. No geographic or language limitations were used in the search. DATA EXTRACTION AND SYNTHESIS The PRISMA and MOOSE guidelines were followed for data extraction. The Newcastle-Ottawa Scale was used to evaluate the risk of bias of included studies. Crohn disease and ulcerative colitis were analyzed separately and random-effects model meta-analysis was conducted. A subgroup analysis was performed on psoriatic arthritis. MAIN OUTCOMES AND MEASURES The risk and odds of IBD, Crohn disease, and ulcerative colitis in patients with psoriasis. RESULTS A total of 5 case-control or cross-sectional studies and 4 cohort studies with 7 794 087 study participants were included. Significant associations were found between psoriasis and Crohn disease (odds ratio, 1.70; 95% CI, 1.20-2.40) and between psoriasis and ulcerative colitis (odds ratio, 1.75; 95% CI, 1.49-2.05). Patients with psoriasis had an increased risk of Crohn disease (risk ratio, 2.53; 95% CI, 1.65-3.89) and ulcerative colitis (risk ratio, 1.71; 95% CI, 1.55-1.89). CONCLUSIONS AND RELEVANCE These findings suggest that psoriasis is significantly associated with IBD. Gastroenterology consultation may be indicated when patients with psoriasis present with bowel symptoms.

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Association Between Inflammatory Bowel Disease and Both Psoriasis and Psoriatic Arthritis

2022

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ImportancePsoriasis, psoriatic arthritis, and inflammatory bowel disease, ie, Crohn disease and ulcerative colitis, are chronic systemic immune-mediated disorders affecting an increasing proportion of adults and children worldwide. Observational studies have suggested an association between inflammatory bowel disease and psoriasis and vice versa. So far, however, it remains unclear whether and in which direction causal relationships exist.ObjectiveTo investigate the association between inflammatory bowel disease, particularly Crohn disease and ulcerative colitis, and psoriasis or psoriatic arthritis.Design, Setting, and ParticipantsA bidirectional 2-sample mendelian randomization study was conducted using summary statistics from genome-wide association studies including up to 463 372 European individuals. Total and direct effects were derived performing an iterative radial and robust inverse-variance weighted method within the univariable and multivariable mendelian randomization setting, respectively. Causal estimates were verified using a validation inflammatory bowel disease sample, a series of pleiotropy-robust mendelian randomization methods, and sensitivity analyses based on a PhenoScanner search in conjunction with network analysis. Data analysis was performed from April to May 2022.Main Outcomes and MeasuresInflammatory bowel disease, Crohn disease, ulcerative colitis, psoriasis, and psoriatic arthritis were used as both exposures and outcomes.ResultsThe European samples included 12 882 cases of inflammatory bowel disease and 5621 cases of psoriasis. The proportion of women ranged between 48% and 56%. Genetically predicted inflammatory bowel disease was associated with higher risk of psoriasis (pooled odds ratio [OR], 1.10; 95% CI, 1.05-1.15; P &lt; .001) and psoriatic arthritis (pooled OR, 1.10; 95% CI, 1.04-1.18; P = .003). In contrast with ulcerative colitis, the Crohn disease subentity was associated with psoriasis (OR, 1.16; 95% CI, 1.12-1.20; P &lt; .001) and psoriatic arthritis (OR, 1.13; 95% CI, 1.06-1.20; P &lt; .001). Regarding the reverse directions, no notable associations could be found.Conclusions and RelevanceFindings of this mendelian randomization study support a causal effect between inflammatory bowel disease and psoriasis as well as psoriatic arthritis, but not vice versa. It seems that especially Crohn disease and not ulcerative colitis is responsible for the causal effect of inflammatory bowel disease on both psoriasis outcomes. These findings have implications for the management of inflammatory bowel disease and psoriasis in clinical practice.

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Cutaneous manifestations of gastrointestinal disease

Cited by 127 publications

References 134 publications

Síndromes paraneoplásicos en tumores gastrointestinales. Revisión de tema

Síndromes paraneoplásicos en tumores gastrointestinales. Revisión de tema

Association of Psoriasis With Inflammatory Bowel Disease

Association Between Inflammatory Bowel Disease and Both Psoriasis and Psoriatic Arthritis

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