Differential Diagnosis for Rash with Cancer that Comes and Goes
- Single most likely diagnosis
- Sweet's syndrome: A condition characterized by the sudden onset of fever, leukocytosis, and tender, erythematous, well-demarcated papules and plaques, often associated with underlying malignancies, particularly hematologic cancers. The rash can be intermittent and may resolve on its own or with treatment.
- Other Likely diagnoses
- Leukemia cutis: A skin manifestation of leukemia, where malignant cells infiltrate the skin, causing a variety of lesions, including papules, plaques, and nodules. The rash can wax and wane with disease activity.
- Lymphomatoid papulosis: A rare skin condition characterized by recurrent, self-healing papules and nodules, often associated with lymphoma or other hematologic malignancies.
- Paraneoplastic pemphigus: A rare autoimmune disorder associated with underlying malignancies, particularly lymphoma and leukemia, characterized by blistering skin lesions and mucosal involvement.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cutaneous T-cell lymphoma (e.g., mycosis fungoides): A type of non-Hodgkin lymphoma that primarily affects the skin, causing patches, plaques, and tumors. While not typically intermittent, it can have a varied presentation and is crucial to diagnose early due to its potential for progression.
- Angioinvasive fungal infections (e.g., aspergillosis): In immunocompromised patients, particularly those with hematologic malignancies, fungal infections can cause skin lesions that may resemble a rash and can be life-threatening if not promptly treated.
- Rare diagnoses
- Erythema gyratum repens: A rare skin condition characterized by wavy, circular lesions, often associated with underlying malignancies, particularly lung, breast, and stomach cancers.
- Necrolytic migratory erythema: A rare skin condition associated with glucagonoma, a type of pancreatic tumor, characterized by necrotic migratory erythema, weight loss, and diabetes mellitus.
- Bazex syndrome: A rare paraneoplastic syndrome characterized by acral erythema, nail changes, and hyperpigmentation, often associated with squamous cell carcinoma of the lung or other malignancies.