Cutaneous manifestations of internal malignancy

BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

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“…Risk of HZ is increased in both solid and haematologic cancers [158, 349, 350], especially leukaemia and lymphoma [137, 158]. …”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…Cancer patients may be immunosuppressed due to malignancy, its treatment, or both [ 12 , 39 , 348 ]. Risk of HZ is increased in both solid and haematologic cancers [ 158 , 349 , 350 ], especially leukaemia and lymphoma [ 137 , 158 ].…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

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“…on 750 internal malignancy patients with 35% women, cervical carcinoma was third most common malignancy (16.66%) among women but no case of cutaneous metastasis was observed. [ 5 ] Skin metastasis is found in 0.8% in Stage I, in Stage II (1.2%), Stage III (1.2%) and Stage IV carcinoma cervix cases (4.8%). Most commonly involved sites on the skin are an abdominal wall, vulva, anterior chest wall and lower extremity.…”

Section: Discussionmentioning

confidence: 99%

Metastatic fungating ulcerative growth on vulva as a presenting feature of carcinoma cervix: A rare case report

Naswa

Marfatia

2015

Indian J Dermatol

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Carcinoma of the cervix is the second to fourth most common malignancy in women. It metastasizes most often to the lungs, bones, and liver. Skin involvement originating from cervical cancer is rare, even in the terminal stages of the disease. Cutaneous metastasis of cervical cancer usually presents as cutaneous nodules, papules/plaques, maculopapular rash, and diffuse inflammatory rash. We report a rare case (only the second reported case to the best of our knowledge) of a 50-year-old woman with cutaneous metastasis in form of fungating ulcerative growth on mons pubis as presenting feature of carcinoma cervix.

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“…Ils sont généralement de la couleur de la peau, mais peuvent être rouges à violacés, bleuâtres, ou noirâtres. Parfois, ils miment un zona, un érysipèle ou une cellulite [7]. Les métastases cutanées ont tendance à se produire dans une région du corps à proximité du site de la tumeur primitive.…”

Section: Discussionunclassified

“…Le pronostic des métastases cutanées des carcinomes gastriques reste sombre, avec une mortalité élevée (moyenne de survie de 7,5 mois [7], d'autant plus que ces métastases cutanées sont souvent associées à d'autres métastases ganglionnaires et péritonéales et sont rarement isolées. Toutefois, les récents progrès de la chimiothérapie ont grandement amélioré la survie [9].…”

Section: Figures 4 Et 5 Epaississement De La Région Antro-pylorique Gunclassified

Métastases cutanées d’une linite gastrique : un cas exceptionnel

Benidamou¹,

Oubaha²,

Hafidi³

et al. 2013

Hegel

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La linite gastrique est un adénocarcinome gastrique infiltrant, caractérisé par la présence de cellules en bague à chaton. La survenue de métastases cutanées lors des linites gastriques est une situation extrêmement rare. Parfois révélatrices de néoplasie gastrique, les métastases cutanées restent de mauvais pronostic. Nous en rapportons une observation originale. Observation : Un patient de 45 ans est hospitalisé pour bilan d'épigastralgies avec vomissements dans un contexte d'altération de l'état général. L'examen cutané retrouve des nodules au niveau de la face et du cuir chevelu. L'endoscopie oeso-gastroduodénale a objectivé la présence d'un processus tumoral bourgeonnant et infiltrant de la région antro-pylorique. L'examen anatomo-pathologique a révélé un adénocarcinome peu différencié à cellules isolées en bague à chaton. La biopsie des nodules cutanés a révélé la localisation cutanée d'un adénocarcinome peu différencié avec contingent à cellules indépendantes en bague à chaton. Le scanner abdominal a objectivé en plus, des adénopathies coelio-mésentériques et ascite de faible abondance avec des lésions osseuses condensantes intéressant le squelette axial en faveur de métastases osseuses. Conclusion : Les métastases cutanées des linites gastriques sont très rares ; elles peuvent prendre des aspects cliniques différents et parfois trompeurs. L'extension se fait surtout par voie lymphatique ; le diagnostic est fait par examen histologique et complément immunohisto-chimique. Le pronostic demeure sombre malgré les progrès de la chimiothérapie.

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Cutaneous manifestations of internal malignancy

Cited by 16 publications

References 6 publications

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Metastatic fungating ulcerative growth on vulva as a presenting feature of carcinoma cervix: A rare case report

Métastases cutanées d’une linite gastrique : un cas exceptionnel

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