[An association of paraneoplastic syndromes in a patient]

Abstract

Background: Erythema gyratum repens is a rare cutaneous marker for internal malignancy and the association with other paraneoplastic syndromes is not unusual.

Case report: We report the case of a 54 year-old man with a three-month history of erythroderma which evolved into erythema gyratum repens; a bronchial carcinoma was discovered. Erythema gyratum repens was associated with acquired ichthyosis, hyperkeratosis of the ears and eosinophilia. Improvement of the paraneoplastic dermatosis was achieved by treatment of the underlying carcinoma with chemotherapy, surgery and radiation. However, the lesions relapsed when metastases appeared. Another regimen of chemotherapy improved the carcinoma and the dermatosis.

Discussion: The parallel course of the carcinoma and the cutaneous eruption strongly supports the diagnosis of a cutaneous paraneoplastic syndrome. Three months prior to erythema gyratum repens, the patient developed a scaling erythroderma. This unusual early manifestation is misleading. Our case highlights the possible association of different paraneoplastic syndromes: initially scaling erythroderma, followed by erythema gyratum repens associated with acquired ichthyosis, hyperkeratosis of the ears and eosinophilia.