Pearls and updates: cutaneous signs of systemic malignancy

Purpose of review Children with systemic malignancies can present with concomitant dermatological manifestations. Cutaneous findings can occur before, during or after diagnosis. Recognizing these features can aid in diagnosis, inform prognosis, and help determine appropriate treatment. Following a review of the literature published over the past two years, we provide an update on cutaneous signs of pediatric systemic malignancies, concentrating on; leukemia cutis, lymphoma cutis, neuroblastoma, sarcomas, Langerhans cell histiocytosis and paraneoplastic syndromes. Recent findings Authors highlight the persistently heterogeneous features of cutaneous manifestations of systemic malignancy. Findings are often nonspecific, and a definitive diagnosis requires skin biopsy with immunophenotyping. Several studies describe dermoscopy features, demonstrating this as a useful tool in clinical evaluation. Genetic mutations underlying the pathogenesis of disease continue to be elucidated. Further, advances in medical treatment led to improved prognosis in many systemic malignancies, with early and aggressive treatment heralding better outcomes. Comprehensive cutaneous evaluation alongside thorough clinical history and review of systems remains of paramount importance as dermatological manifestations of systemic malignancy are notoriously variable with a shared feature of often appearing benign but persisting despite usual treatment. Urgent referral to dermatology is recommended when suspicion for any cutaneous presentation of malignancy arises.

Automated summary

This review provides an update on cutaneous signs of pediatric systemic malignancies, including leukemia cutis, lymphoma cutis, neuroblastoma, sarcomas, Langerhans cell histiocytosis, and paraneoplastic syndromes. The authors highlight the heterogeneous features of these manifestations and emphasize the importance of skin biopsy for definitive diagnosis. Dermoscopy is also described as a useful tool in clinical evaluation. Genetic mutations and advances in medical treatment are further discussed, indicating improved prognosis for many systemic malignancies. Comprehensive cutaneous evaluation alongside thorough clinical history and review of systems remains important in diagnosing and managing these dermatological manifestations.