1. Congenital syndromes of malignancy with cutaneous features
Gardner syndrome
Epidermal cyst, lipomas
fibromas
Gastrointestinal, thyroid
Peutz-jeghers
syndrome
Mucocutaneous
pigmentation
Gastrointestinal, pancreas
other
Howel-Evans
Palmoplanter keratoderma
(tylosis)
Oesophageal
Muller-Torr syndrome
Sebaceous tumors, keratoacnthoma, BCC
Colorectal, other
Cowden syndrome
Tricholemmas, mucosal
Warty hyperplasia
Breast, thyroid, endometrial
Renal, other

2. Congenital syndromes of malignancy with cutaneous features ( Continue)
Neurofibromatosis
Café-au-lait macules,
Neurofibromas, freckling
Schwannoma, gliomas
Leukemias,CNS tumors,
sarcoma
Tuberous sclerosis
Angiofibromas, Periungual fibromas, shagreen patches
Sarcoma, rhabdomyoma,
Renal, angiomyolipoma
Gorlin syndrome
Multiple BCCs, palmer pits, typical facies
Medulloblastoma, breast,
lymphoma
Von Hipple- Lindau
disease
Café- au- lait, hemangiomas
Hemangioblastoma, renal,
Pheochromocytoma
Wiskott- Aldridge
syndrome
Eczema
Lymphoma, leukaemia

3. Cutaneous conditions associated with internal malignancy
Dermatomyositis
27% have malignancy: ovarian ,breast, lung, gastrointestinal
Acanthosis nigricans
Gastrointestinal (poor indicator)
Necrolytic migratory erythema
Glauagonoma
Sweet syndrome
Leukemia, lymphoma
Xanthomas
Multiple myeloma, hematological malignancies
Paraneoplastic pemphigus
lymphoma
Purpura
Lymphoma, leukemia, myeloma
Acanthosis palmaris
Lung
Pruritus
Lymphoma, other
Acquried ichthyosis
Lymphoma

4. Cutaneous conditions associated with internal malignancy (Continue)
Seborrheic keratosis
Lesser-Trelat sign-gastrointestinal, cutaneous lymphoma, leukemia, lung, breast
Erythroderma
Cutaneous lymphoma, sezary syndrome, leukemia lymphoma
Telangiectasia
Cutaneous deposits of internal maslignancy,biliary tract tumors
Superficial/migratory erythema
Pancreatic-also pruritus & nodular panniculitis
Acquired hypertrichosis
lanuginosa
Gastrointestinal, lung-sign of late disease

5. Cutaneous conditions associated with internal malignancy (continue)
Pyoderma gangrenosum
Hematological malignancies
Finger clubbing
Lung, cardiac
Pallor
Anything invasding the bone marrow e.g. leukemia
Diffuse hyperpigmentation
Ectopic ACTH from e.g oat cell carcinoma of the lung
Erythema multiformis
Leukemia, lymphoma
Dermatitis herpetiformis- like eruption
Rarely with some cancers

6. Snippets
Cutaneous deposits of internal malignancy are not uncommon & present as non- specific mobile nodules that may ulcerate. The commonest cause of cutaneous metastases in men is lung cancer & in women , it is breast cancer. The scalp is a common site for metastases, most notably for breast, lung & gastrointestinal cancers. Renal carcinoma may metastasise in mouth. Prostate cancer may present with an unusual zoster- like distribution after perineural & lymphatic spread.
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The commonest cause of leukemia cutis is chronic lymphocytic leukemia. It may presents as papules, nodules, plaques, erythema or bullae. The face & extremities are the commonst site for leukemia cutis& it may show kobnerization.. When CLL infiltrates the face it may result in a leonine facies or a rosea like eruption.
@ Systemic lymphoma rarely infiltrate the skin
@ Lymphamatoid papulosis is a chronic skin eruption of self-healing papulonodules that crust , ulcerate & heal with atrophic scarring.