Ahead of print
Case report
Published online: 2024-03-05

open access

Page views 102
Article views/downloads 37
Get Citation

Connect on Social Media

Connect on Social Media

Can erythrodermic psoriasis be considered a paraneoplastic syndrome in patients with metastatic occult gastric cancer?

Ali Fuat Gürbüz1, Murat Araz1, Fatih Kılıç2, Oguzhan Yıldız1, Muzaffer Ugraklı1, Mehmet Zahid Koçak1, Melek Karakurt Eryılmaz1, Fahriye Kılınç3, Mehmet Artaç1

Abstract

Introduction. Erythrodermic psoriasis is a relatively rare formof psoriasis. It has many etiologies including infection, inflammatory skin diseases,malignancy, and systemic drug reactions. Itmay be seen more frequently in hematological malignancies. To our knowledge, this is the first reported case of paraneoplastic erythrodermic psoriasis in gastric cancer. 

Case report. A 59-year-old male patient, who was diagnosed with psoriasis 5 years earlier, presented with severe erythroderma resistant to both local and immunosuppressive treatments. During treatment, hewas diagnosed with pathological and radiological metastatic occult gastric cancer and treated with a modified FOLFOX-6 chemotherapy protocol that was planned every 14 days. After six cycles of chemotherapy, a clinically significant benefit was observed in control examination. Extensive skin lesions almost completely resolved after chemotherapy. Erythroderma and pruritus symptoms completely regressed. The patient continues his treatment. 

Conclusions. Erythrodermic psoriasis may be considered a paraneoplastic syndrome associated with malignant disorders, and therefore paraneoplastic syndrome should be considered in the treatment of these patients.

Article available in PDF format

View PDF Download PDF file

References

  1. Tomasini C, Aloi F, Solaroli C, et al. Psoriatic erythroderma: a histopathologic study of forty-five patients. Dermatology. 1997; 194(2): 102–106.
  2. Gethi.org. Madrid: Grupo Español Tumores Huérfanos e Infrecuentes (GETHI). http://www.gethi.org/Portals/0/libro_digital_oncologia-V2.pd.
  3. Mistry N, Gupta A, Alavi A, et al. A Review of the Diagnosis and Management of Erythroderma (Generalized Red Skin). Adv Skin Wound Care. 2015; 28(5): 228–236.
  4. Prizment AE, Alonso A, Folsom AR, et al. Association between psoriasis and incident cancer: the Iowa's Women's Health Study. Cancer Causes Control. 2011; 22(7): 1003–1010.
  5. King LE, Dufresne RG, Lovett GL, et al. Erythroderma: review of 82 cases. South Med J. 1986; 79(10): 1210–1215.
  6. Chen SX, Hinds BR, Goodman AM, et al. Erythrodermic Psoriasis in a Man with Monoclonal B-cell Lymphocytosis. Cureus. 2017; 9(12): e1936.
  7. Li Y, Wen Y, You R, et al. Erythrodermic psoriasis precipitated by B-cell chronic lymphocytic leukemia. Dermatol Ther. 2021; 34(3): e14904.
  8. Keighley MRB. Gastrointestinal cancers in Europe. Aliment Pharmacol Ther. 2003; 18 Suppl 3: 7–30.
  9. Comella P, Franco L, Casaretti R, et al. Emerging role of capecitabine in gastric cancer. Pharmacotherapy. 2009; 29(3): 318–330.
  10. Tatsuta M, Iishi H, Okuda S, et al. Prospective evaluation of diagnostic accuracy of gastrofiberscopic biopsy in diagnosis of gastric cancer. Cancer. 1989; 63(7): 1415–1420, doi: 10.1002/1097-0142(19890401)63:7<1415::aid-cncr2820630731>3.0.co;2-9.
  11. Gottlieb AB, Deodhar A, Mcinnes IB, et al. Long-term safety of secukinumab in patients with moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis: integrated pooled clinical trial and post-marketing surveillance data. Arthritis Res Ther. 2019; 21(1): 111.
  12. Lee JW, Jung KJ, Kim TG, et al. Risk of malignancy in patients with psoriasis: a 15-year nationwide population-based prospective cohort study in Korea. J Eur Acad Dermatol Venereol. 2019; 33(12): 2296–2304.
  13. Valenti M, Pavia G, Gargiulo L, et al. Biologic therapies for plaque type psoriasis in patients with previous malignant cancer: long-term safety in a single- center real-life population. J Dermatolog Treat. 2022; 33(3): 1638–1642.
  14. Bellinato F, Gisondi P, Maurelli M, et al. IL-17A inhibitors in patients with chronic plaque psoriasis and history of malignancy: A case series with systematic literature review. Dermatol Ther. 2021; 34(2): e14889.
  15. Pellegrini C, Esposito M, Rossi E, et al. Secukinumab in Patients with Psoriasis and a Personal History of Malignancy: A Multicenter Real-Life Observational Study. Dermatol Ther (Heidelb). 2022; 12(11): 2613–2626.
  16. Pelosof LC, Gerber DE. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc. 2010; 85(9): 838–854.
  17. Nast A, Altenburg A, Augustin M, et al. Deutsche S3-Leitlinie zur Therapie der Psoriasis vulgaris, adaptiert von EuroGuiDerm - Teil 2: Therapiemonitoring, besondere klinische Situationen und Komorbidität. J Dtsch Dermatol Ges. 2021; 19(7): 1092–1117.