Erysipelas carcinomatosum C80.x2

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

carcinoma erysipelatoides

Definition
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Extensive penetration of the skin with tumor cells through metastasis, especially via the lymph vessels of the lower dermis and subcutis. Occurrence mainly in mamma carcinoma. More rarely in carcinomas of the pancreas, stomach, lung, rectum and ovary. Transition to a cancer en cuirasse possible. S.a. skin metastasis. Analogous clinical pictures may also be obtained in case of loco-regional metastasis of malignant melanoma(Erysipelas melanomatosum).

Clinical features
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Sharply and jaggedly bordered, flamingly reddened, overheated, possibly pressure-dolent, doughy edematous, usually very rough plaques of different size (mostly 2-50 cm, more rarely enclosing a complete body part) which are differently densely occupied with telangiectasia. Frequently elevated marginal wall. The surface often shows an orange peel phenomenon.

Histology
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Tumour cell invasion with dilatation especially of the deep dermal and subcutaneous lymph vessels, hyperemia, oedema, perivascular round cell infiltrate.

Differential diagnosis
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Therapy
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The aim of the treatment is to maintain as high a quality of life as possible with an unfavourable prognosis. Individual skin metastases can be excised. Radiotherapy or cytostasis are possible for extensive metastases. The treatment regimen depends on the spread of the metastases and the primary tumor.

Progression/forecast
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Infaust. 1/3 of patients already have distant metastases at the time of manifestation.

Literature
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  1. Hariry H et al (2000) Erysipelas carcinomatosum in tubular adenocarcinoma of the stomach. dermatologist 51: 950-952
  2. Krumbholz A et al (2006) Erythematous swelling of the left arm in a 70-year old woman. Erysipelas carcinomatosum in breast carcinoma. J Dtsch Dermatol Ges 4:69-71
  3. Lindmaier A et al (1990) 2 cases of melanomatous erysipelas--differential diagnosis and terminology. Dermatologist 41:628-632

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Last updated on: 29.10.2020