From the Guidelines
Cutaneous manifestations of malignancy can present as various skin changes, including unexplained rashes, yellowing of the skin, excessive hair growth, hyperpigmentation, redness or flushing, itching, and new growths or lesions, with specific cancers having characteristic skin findings, such as melanoma presenting as changing moles following the ABCDE rule, as noted in the most recent guidelines 1.
Key Skin Manifestations
- Unexplained rashes
- Yellowing of the skin (jaundice)
- Excessive hair growth
- Hyperpigmentation
- Redness or flushing
- Itching
- New growths or lesions
Specific Cancers and Their Skin Manifestations
- Melanoma: changing moles following the ABCDE rule (Asymmetry, Border irregularity, Color variation, Diameter >6mm, and Evolution) 1
- Non-melanoma skin cancers: pearly bumps or sores that don't heal
- Internal cancers: paraneoplastic syndromes with distinctive skin findings, such as acanthosis nigricans (dark, velvety skin patches) associated with gastrointestinal cancers
Importance of Early Detection
Early detection of skin changes and cancers significantly improves treatment outcomes, with regular skin self-examinations and professional skin checks recommended, especially for those with risk factors like fair skin, family history of skin cancer, or previous excessive sun exposure 1.
Risk Factors
- Male sex
- Age >50 years
- Phenotypic factors (e.g., tendency to sunburn and/or numerous or atypical nevi)
- Genetic predisposition (e.g., germline mutations)
- Personal or family history of melanoma
- Environmental factors (e.g., excessive exposure to UV radiation in people with lighter skin tones) 1
From the Research
Cutaneous Manifestations of Malignancy
The cutaneous manifestations of malignancy, also known as skin cancer, can be divided into several types, including:
- Basal cell carcinoma
- Cutaneous squamous cell carcinoma
- Melanoma
- Merkel cell carcinoma
- Actinic keratoses or squamous cell carcinoma in situ
- Dysplastic naevi
Types of Skin Cancer
According to 2, skin cancer is the most common type of cancer found worldwide, with basal cell carcinoma and cutaneous squamous cell carcinoma being the most common types. Other less common types of skin cancer include melanoma, Merkel cell carcinoma, and actinic keratoses or squamous cell carcinoma in situ.
Diagnosis and Treatment
Complete skin examination is essential in the assessment of dermatology patients, as it can lead to the discovery of skin malignancies that would not have been discovered otherwise 3. Treatment options for skin cancer include excision surgery, Mohs surgery, radiation therapy, and immunotherapy, as well as targeted therapy or immunotherapy in combination with surgery, radiation, or photodynamic therapy 2.
Importance of Skin Self-Examination
Skin self-examination is an important tool in the early detection of skin cancer, but many melanoma patients do not regularly perform thorough skin self-examinations 4. Efforts to promote skin self-examination among melanoma patients should focus on increasing knowledge and self-efficacy and providing education about the why, when, and how of conducting self-examination and mole tracking.
Emerging Therapeutic Avenues
Somatostatin analogues, a therapy targeted to cancer cells that have somatostatin receptors on their surface, may be an alternative treatment target for advanced Merkel cell carcinoma 5. Additionally, educational interventions for primary care providers can improve clinical skin examination for skin cancer, which is essential for early detection and improved prognosis 6.