Wong Christina Yin Bin, Helm Meghan A, Kalb Robert E, Helm Thomas N, Zeitouni Nathalie C
Department of Dermatology, Roswell Park Cancer Institute, University at Buffalo, Buffalo, New York, USA.
N Am J Med Sci. 2013 Sep;5(9):499-504. doi: 10.4103/1947-2714.118918.
Skin metastases are rare in the routine clinical practice of dermatology, but are of major clinical significance because they usually indicate advanced disease. We reviewed the literature on skin metastasis regarding recent trends in clinical presentation and diagnosis of the most common cutaneous lesions. An extensive literature review was conducted using PubMed from May 26, 2011 to July 16, 2013 relating cutaneous metastases. Articles chosen for reference were queried with the following prompts: "Cutaneous metastases", "clinical presentation", "histological features", and "immunohistochemistry". Further searches included "treatment" and "management" options for "metastatic breast", "metastatic colorectal", "metastatic melanoma", "metastatic lung", and "hematologic cancers." We also reviewed the literature on the current management of melanoma as a model for all cutaneous metastatic disease. Our own clinical findings are presented and compared to the literature. Additionally, we highlight the most useful immunohistochemical studies that aid in diagnoses. Several novel therapies and combination therapies such as electrochemotherapy, vemurafenib, and imiquimod will be discussed for palliative treatment of cancers that have been found to improve cutaneous lesions. We review these notable findings and developments regarding skin metastases for the general dermatologist.
皮肤转移瘤在皮肤科的常规临床实践中较为罕见，但具有重要的临床意义，因为它们通常提示疾病已进展至晚期。我们回顾了有关皮肤转移瘤的文献，内容涉及最常见皮肤病变的临床表现和诊断的最新趋势。使用PubMed对2011年5月26日至2013年7月16日期间与皮肤转移相关的文献进行了广泛的综述。选取用于参考的文章通过以下提示词进行检索：“皮肤转移瘤”、“临床表现”、“组织学特征”和“免疫组织化学”。进一步的检索包括“转移性乳腺癌”、“转移性结直肠癌”、“转移性黑色素瘤”、“转移性肺癌”和“血液系统癌症”的“治疗”和“管理”选项。我们还回顾了有关黑色素瘤当前管理的文献，将其作为所有皮肤转移性疾病的一个范例。展示了我们自己的临床发现并与文献进行比较。此外，我们强调了有助于诊断的最有用的免疫组织化学研究。还将讨论几种新的治疗方法和联合治疗方法，如电化学疗法、维莫非尼和咪喹莫特，用于对已发现可改善皮肤病变的癌症进行姑息治疗。我们为普通皮肤科医生综述了有关皮肤转移瘤的这些显著发现和进展。
