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Cutaneous markers of internal malignancy

Author: Vanessa Ngan, Staff Writer, 2004. Updated by Amanda Oakley, Dermatologist, Hamilton, New Zealand, January 2016.

Table of contents

What are cutaneous markers of internal malignancy?

Skin changes may be the first sign of an internal problem including a visceral malignancy. Signs of skin disease may precede, occur with, or follow the detection of associated cancer. These skin diseases can be a feature of undiagnosed cancer and may be the prompt for a thorough examination in patients. Or in a patient whose cancer is in remission, these skin diseases may be the initial sign of cancer recurring.

Cutaneous markers can be classified into 2 major types:

  • Genetically determined syndromes with a cutaneous component (genodermatoses) that predispose at-risk individuals to develop cancer
  • Paraneoplastic syndromes which occur as a result of circulating factor(s) or presumed factors produced by the underlying cancer


Genetic diseases which carry an increased risk of internal malignancy and skin signs as part of the syndrome include:

Paraneoplastic syndromes

Cutaneous paraneoplastic syndromes can be categorised according to the type of lesion they produce.





As well as cutaneous signs and symptoms, paraneoplastic syndromes may affect endocrine, neuromuscular, musculoskeletal, cardiovascular, haematological, gastrointestinal, or renal function.

Paraneoplastic symptoms and signs may be caused by:

  • Immune reaction: antibodies, T cells, or cytokines
  • Hormones or hormone precursors
  • Enzymes
  • Embryonic or fetal proteins
  • Altered metabolic pathways
  • Unknown factors.



  • Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.

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