Паранеопластические дерматозы у детей и взрослых

Клиническая, морфо-иммунологическая и цитогенетическая характеристика злокачесвенных опухолей крайне полиморфна. Не менее разнообразны и паранеопластические кожные проявления, возникающие до манифестации злокачественного новообразования и/или протекающие параллельно с ним. В настоящем обзоре представлены наиболее часто встречающиеся паранеопластические дерматозы: гангренозная пиодермия, дерматомиозит, паранеопластическая пузырчатка, красный волосяной лишай, синдром Базекса, некролитическая мигрирующая эритема, лишай ротонда и синдром Свита. С современных позиций освещены механизмы их развития, клинические проявления и подходы к терапии.

1. Khoschbin T., Loser C., Dippel E. Paraneoplastic skin diseases. Internist 2019;60(8):775–82. DOI: 10.1007/s00108-019-0636-1

2. Didona D., Fania L., Didona B. et al. Paraneoplastic dermatoses: a brief general review and an extensive analysis of paraneoplastic pemphigus and paraneoplastic dermatomyositis. Int J Mol Sci 2020;21(6):2178. DOI: 10.3390/ijms21062178

3. Cohen P.R., Kurzrock R. Sweet’s syndrome revisited: a review of disease concepts. Int J Dermatol 2003;42(10):761–78. DOI: 10.1046/j.1365-4362.2003.01891.x

4. Silva J.A., Mesquita Kde C., Igreja A.C. et al. Paraneoplastic cutaneous manifestations: concepts and updates. An Bras Dermatol 2013;88(1):9–22. DOI: 10.1590/s0365-05962013000100001

5. Brunsting L.A., Goeckerman W.H., O’Leary P.A. Pyoderma (echthyma) gangrenosum: clinical and experimental observations in five cases occurring in adults. Arch Derm Syphilol 1930;22(4): 655–80. DOI: 10.1001/archderm.1930.01440160053009

6. Powell F.C., O’Kane M. Management of pyoderma gangrenosum. Dermatol Clin 2002;20(2):347–55. DOI: 10.1016/s0733-8635(01)00029-8

7. Powell F.C., Su W.P., Perry H.O. Pyoderma gangrenosum: classification and management. J Am Acad Dermatol 1996;34(3):395–409. DOI: 10.1016/s0190-9622(96)90428-4

8. Pereira N., Brites M.M., Goncalo M. et al. Pyoderma gangrenosum – a review of 24 cases observed over 10 years. Int J Dermatol 2013;52(8):938–45. DOI: 10.1111/j.1365-4632.2011.05451

9. Tolkachjov S.N., Fahy A.S., Wetter D.A. et al. Postoperative pyoderma gangrenosum (PG): the Mayo Clinic experience of 20 years from 1994 through 2014. J Am Acad Dermatol 2015;73(4):615–22. DOI: 10.1016/j.jaad.2015.06.054

10. Allen C.P., Hull J., Wilkinson N. et al. Paediatric pyoderma gangrenosum with splenic and pulmonary. Pediatr Dermatol 2013;30(4):497–9. DOI: 10.1111/pde.12138

11. Braswell S., Kostopoulos T., Ortega-Loayza A. Pathophysiology of pyoderma gangrenosum (PG): an updated review. J Am Acad Dermatol 2015;73(4):691–8. DOI: 10.1016/j.jaad.2015.06.021

12. Marzano A.V., Fanoni D., Antiga E. et al. Expression of cytokines, chemokines and other effector molecules in two prototypic autoinflammatory skin diseases, pyoderma gangrenosum and Sweet’s syndrome. Clin Exp Immunol 2014;178(1):48–56. DOI: 10.1111/cei.12394

13. Su W.P., Davis M.D., Weenig R.H. et al. Pyoderma gangrenosum: clinicopathologic correlation and proposed diagnostic criteria. Int J Dermatol 2004;43(11):790–800. DOI: 10.1111/j.1365-4632.2004.02128.x

14. Weenig R.H., Davis M.D.P., Dahl P.R. et al. Skin ulcers misdiagnosed as pyoderma gangrenosum. N Engl J Med 2002;347(18):1412–8. DOI: 10.1056/NEJMoa013383

15. Gameiro A., Pereira N., Cardoso J. et al. Pyoderma gangrenosum: challenges and solutions. Clin Cosmet Investig Dermatol 2015;8: 285–93. DOI: 10.2147/CCID.S61202

16. Weizman A., Huang B., Targan S. et al. Pyoderma gangrenosum among patients with inflammatory bowel disease: a descriptive cohort study. J Cutan Med Surg 2015;19:125–31.

17. Clark L.G., Tolkachjov S.N., Bridges A.G. et al. Pyostomatitis vegetans (PSV)-pyodermatitis vegetans (PDV): a clinicopathologic study of 7 cases at a tertiary referral center. J Am Acad Dermatol 2016;75(3):578–84. DOI: 10.1016/j.jaad.2016.03.047

18. Schoch J.J., Tolkachjov S.N., Cappel J.A. et al. Pediatric pyoderma gangrenosum: a retrospective review of clinical features, etiologic associations, and treatment. Pediatr Dermatol 2017;34(1):39–45. DOI: 10.1111/pde.12990

19. Madkaikar M., Italia K., Gupta M. et al. Leukocyte adhesion deficiency-I with a novel intronic mutation presenting with pyoderma gangrenosum-like lesions. J Clin Immunol 2015;35(4):431–4. DOI: 10.1007/s10875-015-0155-3

20. Kechichian E., Haber R., Mourad N. et al. Pediatric pyoderma gangrenosum: a systematic review and update. Int J Dermatol 2017;56(5):486–95. DOI: 10.1111/ijd.13584

21. Landis E.T., Taheri A., Jorizzo J.L. Gulliver’s sign: a recognizable transition from inflammatory to healing stages of pyoderma gangrenosum. J Dermatolog Treat 2015;26(2):171–2. DOI: 10.3109/09546634.2014.883061

22. Rajan N., Das S., Taylor A. et al. Idiopathic infantile pyoderma gangrenosum with stridor responsive to infliximab. Pediatr Dermatol 2009;26(1):65–9. DOI: 10.1111/j.1525-1470.2008.00825.x

23. Deregnaucourt D., Buche S., Coopman S. et al. Pyoderma gangrenosum with lung involvement treated with infliximab. Ann Dermatol Venereol 2013;140(5):363–6. DOI: 10.1016/j.annder.2013.01.428

24. Miller J., Yentzer B.A., Clark A. et al. Pyoderma gangrenosum: a review and update on new therapies. J Am Acad Dermatol 2010;62(4):646–54. DOI: 10.1016/j.jaad.2009.05.030

25. Mendez E.P., Liptonn R., Ramsey-Goldman R. et al. US Incidence of juvenile dermatomyositis, 1995–1998: results from the National Institute of Arthritis and Musculoskeletal and Skin Diseases registry. Arthritis Rheum 2003;49(3):300–5. DOI: 10.1002/art.11122

26. Rider L.G., Nistala K. The juvenile idiopathic inflammatory myopathies: pathogenesis, clinical and autoantibody phenotypes, and outcomes. J Intern Med 2016;280(1):24–38. DOI: 10.1111/joim.12444

27. Morris P., Dare J. Juvenile dermatomyositis as a paraneoplastic phenomenon: an update. J Pediatr Hematol Onco 2010;32(3):189–91. DOI: 10.1097/MPH.0b013e3181bf29a2

28. Reed A.M., Pachman L., Ober C. Molecular genetic studies of major histocompatibility complex genes in children with juvenile dermatomyositis: increased risk associated with HLA-DQA1 *0501. Hum Immunol 1991;32(4):235–40. DOI: 10.1016/0198-8859(91)90085-n

29. Mamyrova G., Rider LG., Ehrlich A. et al. Environmental factors associated with disease flare in juvenile and adult dermatomyositis. Rheumatology (Oxford) 2017;56(8):1342–7. DOI: 10.1093/rheumatology/kex162

30. Bowles N.E., Dubowitz V., Sewry C.A., Archard L.C. Dermatomyositis, polymyositis, and Coxsackie-B-virus infection. Lancet 1987;1(8540):1004–7. DOI: 10.1016/s0140-6736(87)92271-9

31. Kwa M.C., Silverberg J.I., Ardalan K. Inpatient burden of juvenile dermatomyositis among children in the United States. Pediatr Rheumatol Online J 2018;16(1):70. DOI: 10.1186/s12969-018-0286-1

32. Wienke J., Deakin C.T., Wedderburn L.R. et al. Systemic and tissue inflammation in juvenile dermatomyositis: from pathogenesis to the quest for monitoring tools. Front Immunol 2018;9:2951. DOI: 10.3389/fimmu.2018.02951.

33. Papadopoulou C., McCann L.J. The vasculopathy of juvenile dermatomyositis. Front Pediatr 2018;6:284. DOI: 10.3389/fped.2018.00284

34. Bohan A., Peter J.B. Polymyositis and dermatomyositis (first of two parts). N Engl J Med 1975;292(7):344–7. DOI: 10.1056/NEJM197502132920706

35. Ponyi A., Constantin T., Garami M. et al. Cancer-associated myositis: clinical features and prognostic signs. Ann NY Acad Sci 2005;1051:64–71. DOI: 10.1196/annals.1361.047

36. Buchbinder R., Forbes A., Hall S. et al. Incidence of malignant disease in biopsy-proven inflammatory myopathy. Ann Intern Med 2001;134(12): 1087–95. DOI: 10.7326/0003-4819-134-12-200106190-00008

37. Chen Y.J., Wu C.Y., Shen J.L. Predicting factors of malignancy in dermatomyositis and polymyositis: a case-control study. Br J Dermatol 2001;144(4):825–31. DOI: 10.1046/j.1365-2133.2001.04140.x

38. Buchbinder R., Hill C.L. Malignancy in patients with inflammatory myopathy. Curr Rheumatol Rep 2002;4(5):415–26. DOI: 10.1007/s11926-002-0087-9

39. Bernard P., Bonnetblanc J.M. Dermatomyositis and malignancy. J Invest Dermatol 1993;100(1):128–32. DOI: 10.1111/1523-1747.ep12356956

40. Cleary M.L., Nalesnik M.A., Shearer W.T. et al. Clonal analysis of transplant-associated lymphoproliferations based on the structure of the genomic termini of the Epstein–Barr virus. Blood 1988;72(1):349–52.

41. Kamel O.W., van de Rijn M., LeBrun D.P. et al. Lymphoid neoplasms in patients with rheumatoid arthritis and dermatomyositis: frequency of Epstein–Barr virus and other features associated with immunosuppression. Hum Pathol 1994;25(7):638–43. DOI: 10.1016/0046-8177(94)90295-x

42. Naschitz J.E. Rheumatic syndromes: clues to occult neoplasis. Curr Opin Rheumatol 2001;13(1):62–6. DOI: 10.1097/00002281-200101000-00010

43. Stockton D., Doherty V.R., Brewster D.H. Risk of cancer in patients with dermatomyositis or polymyositis, and followup implications: a Scottish population-based cohort study. Br J Cancer 2001;85(1):41–5. DOI: 10.1054/bjoc.2001.1699

44. Young G., Toretsky J.A., Campbell A.B. et al. Recognition of common childhood malignancies. Am Fam Physician 2000;61(7):2144–54.

45. Swafford C., Roach E.S. Juvenile dermatomyositis and the inflammatory myopathies. Semin Neurol 202040(3):342–8. DOI: 10.1055/s-0040-1705120

46. Anhalt G.J., Kim S.C., Stanley J.R. et al. Paraneoplastic pemphigus. An autoimmune mucocutaneous disease associated with neoplasia. N Eng J Med 1990;323(25):1729–35. DOI: 10.1056/NEJM199012203232503

47. Nguyen V.T., Ndoye A., Bassler K.D. et al. Classification, clinical manifestations, and immunopathological mechanisms of the epithelial variant of paraneoplastic autoimmune multiorgan syndrome: a reappraisal of paraneoplastic pemphigus. Arch Dermatol 2001;137(2):193–206.

48. Solimani F., Maglie R., Pollmann R. et al. Thymoma-associated paraneoplastic autoimmune multiorgan syndrome-from pemphigus to lichenoid dermatitis. Front Immunol 2019;10:1413. DOI: 10.3389/fimmu.2019.01413

49. Kim J.H., Kim S.C. Paraneoplastic pemphigus: paraneoplastic autoimmune disease of the skin and mucosa. Front Immunol 2019;10:1259. DOI: 10.3389/fimmu.2019.01259

50. Mimouni D., Anhalt G.J., Lazarova Z. et al. Paraneoplastic pemphigus in children and adolescents. Br J Dermatol 2002;147(4):725–32. DOI: 10.1046/j.1365-2133.2002.04992.x

51. Paolino G., Didona D., Magliulo G. et al. Paraneoplastic pemphigus: insight into the autoimmune pathogenesis, clinical features and therapy.Int J Mol Sci 2017;18(12):2532. DOI: 10.3390/ijms18122532

52. Lambert J., Bracke S., van Roy F. et al. Serum plakophilin-3 autoreactivity in paraneoplastic pemphigus. Br J Dermatol 2010;163(2):630–2. DOI: 10.1111/j.1365-2133.2010.09845.x

53. Zimmermann J., Bahmer F., Rose C. et al. Clinical and immunopathological spectrum of paraneoplastic pemphigus. J Dtsch Dermatol Ges 2010;8(8):598–606. DOI: 10.1111/j.1610-0387.2010.07380.x

54. Numata S., Teye K., Tsuruta D. et al. Anti-alpha-2-macroglobulinlike-1 autoantibodies are detected frequently and may be pathogenic in paraneoplastic pemphigus. J Investig Dermatol 2013;133(7):1785–93. DOI: 10.1038/jid.2013.65

55. Reich K., Brinck U., Letschert M. et al. Graft-versus-host disease-like immunophenotype and apoptotic keratinocyte death in paraneoplastic pemphigus. Br J Dermatol 1999;141(4):739–46. DOI: 10.1046/j.1365-2133.1999.03123.x

56. Cummins D.L., Mimouni D., Tzu J. et al. Lichenoid paraneoplastic pemphigus in the absence of detectable antibodies. J Am Acad Dermatol 2007;56(1)153–9. DOI: 10.1016/j.jaad.2006.06.007

57. Wang D., Chong V.C., Chong W.S., Oon H.H. A review on pityriasis rubra pilaris. Am J Clin Dermatol 2018;19(3):377–90. DOI: 10.1007/s40257-017-0338-1

58. Griffiths W.A. Pityriasis rubra pilaris. Clin Exp Dermatol 1980;5:105–12.

59. Auffret N., Quint L., Domart P. et al. Pityriasis rubra pilaris in a patient with human immunodeficiency virus infection. J Am Acad Dermatol 1992;27(2 Pt. 1):260–1. DOI: 10.1016/s0190-9622(08)80734-7

60. Lamberg O., Cao S., Sabater-Geib S. et al. A case of recurrent and paraneoplastic pityriasis rubra pilaris. JAAD Case Rep 2021;12:74–6. DOI: 10.1016/j.jdcr.2021.04.025

61. Richey P.M., Fairley J.A., Stone M.S. Transformation from pityriasis rubra pilaris to erythema gyratum repens-like eruption without associated malignancy: a report of 2 cases. JAAD Case Rep 2018;4(9):944–6. DOI: 10.1016/j.jdcr.2018.07.009

62. Hsu Y.S., Lien G.S., Lai H.H. et al. Acrokeratosis paraneoplastica (Bazex syndrome) with adenocarcinoma of the colon: report of a case and review of the literature. J Gastroenterol 2000;35(6):460–4. DOI: 10.1007/s005350070092

63. Akyani M., Mansouri P., Taheri A., Asadi Kani Z. Paraneoplastic acrokeratosis (Bazex syndrome) associated with breast cancer. Klin Exp Dermatol 2004;29:429–30. DOI: 10.1111/j.1365-2230.2004.01540.x

64. Wu S.L., Bai J.G., Xu J. et al. Necrolytic migrating erythema as the first manifestation of a neuroendocrine tumor of the pancreas. World J Surg Oncol 2014;12:220. DOI: 10.1186/1477-7819-12-220

65. Tierney E.P., Badger J. Etiology and pathogenesis of necrolytic migrating erythema: literature review. MedGenMed 2004;6(3):4.

66. Al-Fauri A., Ajarma K., Algazawi S. et al. Glucagonoma and glucagonoma syndrome: a disease report with an overview of recent advances in management. Case Rep Surg 2016;2016:1484089. DOI: 10.1155/2016/1484089

67. Teixeira R.S., Niko M.M., Gideti A.S. Necrolytic migrating erythema associated with glucagonoma: a report on 2 cases. Clinics (Sao Paulo) 2008;63(2):267–70. DOI: 10.1590/s1807-59322008000200016

68. Asri H., Suali M. Leser-trélat sign: think about lung adenocarcinoma. Pan Afr Med J 2018;30:270. DOI: 10.11604/pamj.2018.30.270.16337

69. West L., Carlson M., Wallis L., Goff H.V. A sign of Leser-Trelat and malignant black acanthosis associated with carcinoma of the fallopian tubes. Obstetrics Gynecol 2018;132(5):1116–9. DOI: 10.1097/AOG.0000000000002920

70. Pipkin V.A., Lio P.A. Skin manifestations of malignant neoplasms of internal organs: review. Dermatol Wedge 2008;26(1):1–15. DOI: 10.1016/j.det.2007.08.002

71. Kimayi-Asadi A., Kotcher L.B., Jih M.H. Molecular foundations of hereditary palmar-plantar keratodermy. J Am Acad Dermatol 2002;47(3):327–43. DOI: 10.1067/mjd.2002.124814

72. Chamcheu J.C., Siddiqui I.A., Syed D.N. et al. Keratin gene mutations in human skin diseases and its appendages. Arch Biochim Biophysis 2011;508(2):123–37. DOI: 10.1016/j.abb.2010.12.019

73. Avshalumova L., Fabrikant J., Koriakos A. Review of skin diseases associated with mutations of the connexin gene. Int J Dermatol 2014; 53(2):192–205. DOI: 10.1111/ijd.12062

74. Gedike M.M., Traupe H., Fischer B. et al. On the characteristics of palmar-plantar keratodermia caused by mutation with enhanced loricrin function: family analysis and literature review. Br J Dermatol 2006;154(1):167–71. DOI: 10.1111/j.1365-2133.2005.06995.x

75. Lai-Cheong J.E., Sethuraman G., Ramam M. et al. Recurrent heterozygous missense mutation. p.Gly573Ser in the TRPV3 gene in an Indian boy with sporadic Olmsted syndrome. Br J Dermatol 2012;167(2):440–2. DOI: 10.1111/j.1365-2133.2012.11115.x

76. Badri T., Hafsi W. Pityriasis rotunda. Available at: https://www.ncbi.nlm.nih.gov/books/NBK459240

77. Al-Refu K., Al-Tarawneh A., Odeibat H. Pityriasis rotunda. A clinical study in Jordan: experience of 10 years. Int J Dermatol 2018;57(7):759–62. DOI: 10.1111/ijd.13994

78. Friedmann A.C., Ameen M., Swale V.J. Familial pityriasis rotunda in black-skinned patients; a first report. Brit J Dermatol 2021;156(6):1365–7. DOI: 10.1111/j.1365-2133.2007.07874.x

79. Fuller L.C., Higgins E.M. Racial influences on skin disease. In: Rook’s textbook of dermatology. Ed. by Griffiths C.E.M., Barker J., Bleiker T.O. et al. 9th edn. 2017.

80. Wick M.R., Patterson J. Cutaneous paraneoplastic syndromes. Semin Diagn Pathol 2019;36(4):211–28. DOI: 10.1053/j.semdp.2019.01.001

81. Bonito F., Costin A., Cunha H., Bártolo E. Pityriasis rotunda. Australas J Dermatol 2020;61(3):275–6. DOI: 10.1111/ajd.13261

82. Suzuki Y., Aoshima M., Fujiyama T. et al. Pityriasis rotunda associated with acute myeloid leukemia. J Dermatol 2018;45(1):105–6. DOI: 10.1111/1346-8138.13802

83. Riley С.A., Badri T., Hafsi W. Pityriasis Rotunda. Treasure Island (FL): StatPearls Publishing, 2022.

84. Косарева И.Н., Шабалин А.Р., Епишева Н.Н. Синдром Свита. Клиническая дерматология и венерология 2014;12(4):18–21.

85. Halpern J., Salim A. Pediatric Sweet syndrome: case report and literature review. Pediatr Dermatol 2009;26:452–7.

86. García-Romero M.T., Ho N. Pediatric Sweet syndrome. A retrospective study. Int J Dermatol 2015;54(5):518–22. DOI: 10.1111/ijd.12372

87. Cunha D.G., Campos-do-Carmo G., Marujo J.M., Verardino G.C. Paraneoplastic Sweet’s syndrome. An Bras Dermatol 2018;93(4):576–8. DOI: 10.1590/abd1806-4841.20187353

88. Gille J. Sweet’s syndrome as initial presentation of diffuse large B-cell lymphoma. J Am Acad Dermatol 2002;46(2):11–3. DOI: 10.1067/mjd.2002.104970

89. Morgan K.W., Callen J.P., Kentucky L. Sweet’s syndrome in acute myelogenous leukemia presenting as periorbital cellulitis with an infiltrate of leukemic cells. J Am Acad Dermatol 2001;45(4):590–5. DOI: 10.1067/mjd.2001.119032

90. Bamelis M., Boyden B., Sente F. et al: Sweet’s syndrome and acute myelogenous leukemia in a patient who presented with a sudden massive swelling of the tongue. Dermatology 1995;190(4):335–7. DOI: 10.1159/000246736

91. García-Río I., Pérez-Gala S., Aragüés M. et al. Sweet’s syndrome on the area of postmastectomy lymphoedema. J Eur Acad Dermatol Venereol 2006;20(4):401–5. DOI: 10.1111/j.1468-3083.2006.01460.x

92. Shugarman I.L., Schmit J.M., Sbicca J.A. et al. Easily missed extracutaenous manifestation of malignancy associated Sweet’s syndrome: systemic inflammatory response syndrome. J Clin Oncol 2011;29(24):702–5. DOI: 10.1200/JCO.2011.35.3540

93. Paydas S., Sahin B., Zorludemir S. Sweet’s syndrome accompanying leukaemia: seven cases and review of the literature. Leuk Res 2000;24(1):83–6. DOI: 10.1016/s0145-2126(99)00140-x

94. Arun B., Berberian B., Azumi N. et al. Sweet’s syndrome during treatment with all-trans retinoic acid in a patient with acute promyelocytic leukemia. Leuk Lymphoma 1998;31:613–5. DOI: 10.3109/10428199809057622