• 南京醫(yī)科大學(xué)鼓樓臨床醫(yī)學(xué)院普通外科(江蘇南京 210008);

目的  提高臨床醫(yī)生對(duì)伴發(fā)皮膚病的惡性腫瘤的警惕和認(rèn)識(shí),減少漏診。
方法  對(duì)筆者所在醫(yī)院近兩年診治的2例分別以紅皮病和皮肌炎為首發(fā)表現(xiàn)的胃癌患者的臨床資料并結(jié)合相關(guān)文獻(xiàn)進(jìn)行分析。
結(jié)果  2例患者均因皮膚病入院,行胃鏡檢查診斷為胃癌,行手術(shù)切除,術(shù)后病理學(xué)檢查證實(shí)為胃癌伴發(fā)皮膚病。
結(jié)論  伴腫瘤性皮膚病可以看做是內(nèi)臟惡性腫瘤的早期表現(xiàn),該類患者需要通過(guò)腫瘤標(biāo)志物、胃鏡、PET/CT等檢查以排除內(nèi)臟腫瘤。

引用本文: 戈偉,滕步偉,余德才,陳剛,鄭黎明,丁義濤. 以皮膚病為首發(fā)表現(xiàn)的胃癌2例報(bào)道并文獻(xiàn)復(fù)習(xí). 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(10): 1127-1131. doi: 復(fù)制

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2. Brenner S, Tamir E, Maharshak N, et al. Cutaneous manifestations of internal malignancies[J]. Clin Dermatol, 2001, 19(3):290-297.
3. Ofuji S, Furakawa F, Miyachi Y, et al. Papuloerythroderma[J]. Dermatologica, 1984, 169(3): 125-130.
4. Sugita K, Koga C, Yoshiki R, et al. Papuloerythroderma caused by aspirin[J]. Arch Dermatol, 2006, 142(6):792-793.
5. Sugita K, Kabashima K, Nakashima D, et al. Papuloerythroderma of Ofuji induced by furosemid[J]. J Am Acad Dermatol, 2008, 58 (2 Suppl):S54-S55.
6. De Vries HJ, Koopmans AK, Starink TM, et al. Ofuji papuloerythroderma associated with Hodgkin’s lymphoma[J]. Br J Dermatol, 2002, 147(1): 186-187.
7. Martinez-Barranca MI, Muñoz-Pérez MA, García-Morales I, et al. Ofuji papuloerythroderma evolving to cutaneus T-cell lymphoma[J]. J Eur Acad Dermatol Venereol, 2005, 19(1): 104-106.
8. Pereiro M Jr, Sánchez-Aguilar D, Pereiro Ferreirós MM, et al. Cutaneous T-cell lymphoma:an expression of papuloerythrodermaof Ofuji[J]. J Eur Acad Dermatol Venereol, 2003, 17(2): 240-241.
9. Shimauchi T, Sugita K, Nakamura M, et al. Leukaemic cutaneousT-cell lymphoma-manifesting papuloerythroderma with CD3― CD4+phenotype[J]. Acta Derm Venereol, 2010, 90(1): 68-72.
10. Guisado Vasco P, Fraile Rodríguez G, Barbolla Diaz I, et al. Comments on:papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol, 2010, 20(3): 418.
11. Salgüero I, Moreno C, Aguayo-Leiva I, et al. Papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol, 2009, 19(4): 396-397.
12. Wong CL, Houghton JB, Andrew S, et al. Papuloerythroderma of Ofuji associated with acute myeloid leukaemia[J]. Clin Exp Dermatol, 2003, 28(3): 277-279.
13. Hur J, Seong JY, Choi TS, et al. Mycosis fungoides presentingas Ofuji’s papuloerythroderma[J]. J Eur Acad Dermatol Venereol,.
14. Shimauchi T, Ohshima A, Tokura Y. Folliculotropic mycosis fungoides presenting as papuloerythroderma[J]. J Dermatol, 2006, 33(7): 498-500.
15. Kim SW, Kang YS, Park SH, et al. A case of erythrodermicdermatomyositis associated with gastric cancer[J]. Ann Dermatol,.
16. Lonnee ER, Toonstra J, van der Putte SC, et al. Papuloerythroderma of Ofuji in a HIV-infected patient[J]. Br J Dermatol, 1996, 135(3): 500-501.
17. García-Patos V, Repiso T, Rodríguez-Cano L, et al. Ofuji papuloerythroderma in a patient with the acquired immunodeficiency syndrome[J]. Dermatology, 1996, 192(2): 164-166.
18. Pectasides D, Koumpou M, Gaglia A, et al. Dermatomyositisassociated with breast cancer[J]. Anticancer Res, 2006, 26(3B):.
19. Celebi S, Gul A, Kamali S, et al. Amyopathic dermatomyositis associated with cervical cancer[J]. Clin Rheumatol, 2001, 20(6):.
20. Chao LW, Wei LH. Dermatomyositis as the initial presentation of ovarian cancer[J]. Taiwan J Obstet Gynecol, 2009, 48(2):178-180.
21. Scheinfeld NS. Ulcerative paraneoplastic dermatomyositis secon-dary to metastatic breast cancer[J]. Skinmed, 2006, 5(2):94-96.
22. Nakamura S, Umeda T, Yokozeki H, et al. Possible involvement of tumour-derived interleukin-6 in dermatomyositis associated with cervical squamous cell carcinoma[J]. Br J Dermatol, 1997, 136(3):475-476.
23. Valverde R, Sanchez-Caminero MP, Calzado L, et al. Dermatomyositis and punctate porokeratotic keratoderma as paraneoplastic syndrome of ovarian carcinoma[J]. Actas Dermosifiliogr, 2007, 98(5):358-360.
24. Dhungel S, Chalise SN, Kandel S, et al. Dysphagia as a presentingsymptom in a case of dermatomyositis and occult gastric malignancy[J]. Nepal Med Coll J, 2005, 7(1):77-78.
25. Castro C, Khan Y, Awasum M, et al. Case report:primary gastricmelanoma in a patient with dermatomyositis[J]. Am J Med Sci, 2008, 336(3):282-284.
26. Przybylski G, Jarzemska A, Czerniak J, et al. A case report of a patient with dermatomyositis as a prodromal sign of lung cancer[J]. Pol Arch Med Wewn, 2008, 118(3):143-147.
27. Park JK, Subhawong AP, Ziminski CM, et al. Dermatomyositis as the initial presentation of a large anaplastic T-cell lymphoma[J]. J Clin Oncol, 2011, 29(13):e378- e380.
28. Shrivastav A, Kumar V, Pal J. Dermatomyositis associated with acute myelocytic leukemia[J]. Rheumatol Int, 2010, 30(5):671-673.
29. Mooney CJ, Dunphy EJ, Stone B, et al. Identification of autoan-tibodies elicited in a patient with prostate cancer presenting asdermatomyositis[J]. Int J Urol, 2006, 13(3):211-217.
30. Hassoun N, Agabrya A, Levy Y. Mediastinal cancer presenting as dermatomyositis—a case report[J]. Harefuah, 2011, 150(7):574-577, 617, 618.
31. Kee SJ, Kim TJ, Lee SJ, et al. Dermatomyositis associated with hepatitis B virus-related hepatocellular carcinoma[J]. RheumatolInt, 2009, 29(5):595-599.
32. Shinohara N, Harabayashi T, Suzuki S, et al. Advanced renal pelvic carcinoma associated with dermatomyositis[J]. Int J Urol, 2005, 12(10):906-908.
33. Farthing CF, Staughton RC, Harper JI, et al. Papuloerythroderma:a further case with the “deck chair sign”[J]. Dermatologica, 1986, 172(1): 65-66.
34. Bech-Thomsen N, Thomsen K. Ofuji’s papuloerythroderma:a study of 17 cases[J]. Clin Exp Dermatol, 1998, 23(2): 79-83.
35. Sunami K, Taniguchi H, Moriyama T, et al. Papuloerythrodermaassociated with gastric cancer;report of a case[J]. Nippon Shokakibyo Gakkai Zasshi, 1995, 92(9): 1285-1288.
36. Watanabe M, Kimura T, Murasawa A. A case report of apatient with papuloerythroderma (Ofuji) and gastric cancer[J]. Jpn J Clin Dermatol, 2002, 56: 445-447.
37. Nazzari G, Sabbatini C. Ofuji’s papuloerythroderma. An association with early gastric cancer[J]. Eur J Dermatol, 1999, 9(4):317-318.
38. Nomura T, Kodama K, Moriuchi R, et al. Papuloerythroderma of Ofuji associated with early gastric cancer[J]. Int J Dermatol, 2008, 47(6): 590-591.
39. Schepers C, Malvehy J, Azon-Masoliver A, et al. Papuloerythroderma of Ofuji: a report of 2 cases including the first European case associated with visceral carcinoma[J]. Dermatology, 1996, 193(2):131-135.
40. Chong VH, Lim CC. Erythroderma as the first manifestation of colon cancer[J]. South Med J, 2009, 102(3): 334-335.
41. Nishijima S. Papuloerythroderma associated with hepatocellular carcinoma[J]. Br J Dermatol, 1998, 139(6): 1115-1116.
42. Kameyama H, Shirai Y, Date K, et al. Gallbladder carcinoma presenting as exfoliative dermatitis (erythroderma)[J]. Int J Gastrointest Cancer, 2005, 35(2): 153-155.
43. Akioka J, Moriwaki SI, Yagi H, et al. A case of papuloerythroderma:an association with early cancer[J]. Acta Dermatol, 1988, 83: 181-184.
44. Raffel GD, Gravallese EM, Schwab P, et al. Diagnostic dilemmasin oncology: case 2. Dermatomyositis and ovarian cancer[J]. J Clin Oncol, 2001, 19(23):4341-4343.
45. Callen JP. The value of malignancy evaluation in patients with dermatomyositis[J]. J Am Acad Dermatol, 1982, 6(2):253-259.
46. Callen JP. Dermatomyositis and female malignancy[J]. J Surg Oncol, 1986, 32(2):121-124.
47. -440.
48. , 16(4):393-396.
49. , 21(4): 435-439.
50. -2331.
  1. 1. Schimrigch K, Blaes F. Paraneoplastic syndromes[J]. Zh NevrolPsikhiatr Im S S Korsakova, 2002, 102(11):48-49.
  2. 2. Brenner S, Tamir E, Maharshak N, et al. Cutaneous manifestations of internal malignancies[J]. Clin Dermatol, 2001, 19(3):290-297.
  3. 3. Ofuji S, Furakawa F, Miyachi Y, et al. Papuloerythroderma[J]. Dermatologica, 1984, 169(3): 125-130.
  4. 4. Sugita K, Koga C, Yoshiki R, et al. Papuloerythroderma caused by aspirin[J]. Arch Dermatol, 2006, 142(6):792-793.
  5. 5. Sugita K, Kabashima K, Nakashima D, et al. Papuloerythroderma of Ofuji induced by furosemid[J]. J Am Acad Dermatol, 2008, 58 (2 Suppl):S54-S55.
  6. 6. De Vries HJ, Koopmans AK, Starink TM, et al. Ofuji papuloerythroderma associated with Hodgkin’s lymphoma[J]. Br J Dermatol, 2002, 147(1): 186-187.
  7. 7. Martinez-Barranca MI, Muñoz-Pérez MA, García-Morales I, et al. Ofuji papuloerythroderma evolving to cutaneus T-cell lymphoma[J]. J Eur Acad Dermatol Venereol, 2005, 19(1): 104-106.
  8. 8. Pereiro M Jr, Sánchez-Aguilar D, Pereiro Ferreirós MM, et al. Cutaneous T-cell lymphoma:an expression of papuloerythrodermaof Ofuji[J]. J Eur Acad Dermatol Venereol, 2003, 17(2): 240-241.
  9. 9. Shimauchi T, Sugita K, Nakamura M, et al. Leukaemic cutaneousT-cell lymphoma-manifesting papuloerythroderma with CD3― CD4+phenotype[J]. Acta Derm Venereol, 2010, 90(1): 68-72.
  10. 10. Guisado Vasco P, Fraile Rodríguez G, Barbolla Diaz I, et al. Comments on:papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol, 2010, 20(3): 418.
  11. 11. Salgüero I, Moreno C, Aguayo-Leiva I, et al. Papuloerythroderma of Ofuji associated with chronic lymphatic leukaemia[J]. Eur J Dermatol, 2009, 19(4): 396-397.
  12. 12. Wong CL, Houghton JB, Andrew S, et al. Papuloerythroderma of Ofuji associated with acute myeloid leukaemia[J]. Clin Exp Dermatol, 2003, 28(3): 277-279.
  13. 13. Hur J, Seong JY, Choi TS, et al. Mycosis fungoides presentingas Ofuji’s papuloerythroderma[J]. J Eur Acad Dermatol Venereol,.
  14. 14. Shimauchi T, Ohshima A, Tokura Y. Folliculotropic mycosis fungoides presenting as papuloerythroderma[J]. J Dermatol, 2006, 33(7): 498-500.
  15. 15. Kim SW, Kang YS, Park SH, et al. A case of erythrodermicdermatomyositis associated with gastric cancer[J]. Ann Dermatol,.
  16. 16. Lonnee ER, Toonstra J, van der Putte SC, et al. Papuloerythroderma of Ofuji in a HIV-infected patient[J]. Br J Dermatol, 1996, 135(3): 500-501.
  17. 17. García-Patos V, Repiso T, Rodríguez-Cano L, et al. Ofuji papuloerythroderma in a patient with the acquired immunodeficiency syndrome[J]. Dermatology, 1996, 192(2): 164-166.
  18. 18. Pectasides D, Koumpou M, Gaglia A, et al. Dermatomyositisassociated with breast cancer[J]. Anticancer Res, 2006, 26(3B):.
  19. 19. Celebi S, Gul A, Kamali S, et al. Amyopathic dermatomyositis associated with cervical cancer[J]. Clin Rheumatol, 2001, 20(6):.
  20. 20. Chao LW, Wei LH. Dermatomyositis as the initial presentation of ovarian cancer[J]. Taiwan J Obstet Gynecol, 2009, 48(2):178-180.
  21. 21. Scheinfeld NS. Ulcerative paraneoplastic dermatomyositis secon-dary to metastatic breast cancer[J]. Skinmed, 2006, 5(2):94-96.
  22. 22. Nakamura S, Umeda T, Yokozeki H, et al. Possible involvement of tumour-derived interleukin-6 in dermatomyositis associated with cervical squamous cell carcinoma[J]. Br J Dermatol, 1997, 136(3):475-476.
  23. 23. Valverde R, Sanchez-Caminero MP, Calzado L, et al. Dermatomyositis and punctate porokeratotic keratoderma as paraneoplastic syndrome of ovarian carcinoma[J]. Actas Dermosifiliogr, 2007, 98(5):358-360.
  24. 24. Dhungel S, Chalise SN, Kandel S, et al. Dysphagia as a presentingsymptom in a case of dermatomyositis and occult gastric malignancy[J]. Nepal Med Coll J, 2005, 7(1):77-78.
  25. 25. Castro C, Khan Y, Awasum M, et al. Case report:primary gastricmelanoma in a patient with dermatomyositis[J]. Am J Med Sci, 2008, 336(3):282-284.
  26. 26. Przybylski G, Jarzemska A, Czerniak J, et al. A case report of a patient with dermatomyositis as a prodromal sign of lung cancer[J]. Pol Arch Med Wewn, 2008, 118(3):143-147.
  27. 27. Park JK, Subhawong AP, Ziminski CM, et al. Dermatomyositis as the initial presentation of a large anaplastic T-cell lymphoma[J]. J Clin Oncol, 2011, 29(13):e378- e380.
  28. 28. Shrivastav A, Kumar V, Pal J. Dermatomyositis associated with acute myelocytic leukemia[J]. Rheumatol Int, 2010, 30(5):671-673.
  29. 29. Mooney CJ, Dunphy EJ, Stone B, et al. Identification of autoan-tibodies elicited in a patient with prostate cancer presenting asdermatomyositis[J]. Int J Urol, 2006, 13(3):211-217.
  30. 30. Hassoun N, Agabrya A, Levy Y. Mediastinal cancer presenting as dermatomyositis—a case report[J]. Harefuah, 2011, 150(7):574-577, 617, 618.
  31. 31. Kee SJ, Kim TJ, Lee SJ, et al. Dermatomyositis associated with hepatitis B virus-related hepatocellular carcinoma[J]. RheumatolInt, 2009, 29(5):595-599.
  32. 32. Shinohara N, Harabayashi T, Suzuki S, et al. Advanced renal pelvic carcinoma associated with dermatomyositis[J]. Int J Urol, 2005, 12(10):906-908.
  33. 33. Farthing CF, Staughton RC, Harper JI, et al. Papuloerythroderma:a further case with the “deck chair sign”[J]. Dermatologica, 1986, 172(1): 65-66.
  34. 34. Bech-Thomsen N, Thomsen K. Ofuji’s papuloerythroderma:a study of 17 cases[J]. Clin Exp Dermatol, 1998, 23(2): 79-83.
  35. 35. Sunami K, Taniguchi H, Moriyama T, et al. Papuloerythrodermaassociated with gastric cancer;report of a case[J]. Nippon Shokakibyo Gakkai Zasshi, 1995, 92(9): 1285-1288.
  36. 36. Watanabe M, Kimura T, Murasawa A. A case report of apatient with papuloerythroderma (Ofuji) and gastric cancer[J]. Jpn J Clin Dermatol, 2002, 56: 445-447.
  37. 37. Nazzari G, Sabbatini C. Ofuji’s papuloerythroderma. An association with early gastric cancer[J]. Eur J Dermatol, 1999, 9(4):317-318.
  38. 38. Nomura T, Kodama K, Moriuchi R, et al. Papuloerythroderma of Ofuji associated with early gastric cancer[J]. Int J Dermatol, 2008, 47(6): 590-591.
  39. 39. Schepers C, Malvehy J, Azon-Masoliver A, et al. Papuloerythroderma of Ofuji: a report of 2 cases including the first European case associated with visceral carcinoma[J]. Dermatology, 1996, 193(2):131-135.
  40. 40. Chong VH, Lim CC. Erythroderma as the first manifestation of colon cancer[J]. South Med J, 2009, 102(3): 334-335.
  41. 41. Nishijima S. Papuloerythroderma associated with hepatocellular carcinoma[J]. Br J Dermatol, 1998, 139(6): 1115-1116.
  42. 42. Kameyama H, Shirai Y, Date K, et al. Gallbladder carcinoma presenting as exfoliative dermatitis (erythroderma)[J]. Int J Gastrointest Cancer, 2005, 35(2): 153-155.
  43. 43. Akioka J, Moriwaki SI, Yagi H, et al. A case of papuloerythroderma:an association with early cancer[J]. Acta Dermatol, 1988, 83: 181-184.
  44. 44. Raffel GD, Gravallese EM, Schwab P, et al. Diagnostic dilemmasin oncology: case 2. Dermatomyositis and ovarian cancer[J]. J Clin Oncol, 2001, 19(23):4341-4343.
  45. 45. Callen JP. The value of malignancy evaluation in patients with dermatomyositis[J]. J Am Acad Dermatol, 1982, 6(2):253-259.
  46. 46. Callen JP. Dermatomyositis and female malignancy[J]. J Surg Oncol, 1986, 32(2):121-124.
  47. 47. -440.
  48. 48. , 16(4):393-396.
  49. 49. , 21(4): 435-439.
  50. 50. -2331.