PRAGUE — Unexplained erythema should raise suspicion about a possible underlying malignancy, according to a review of cases as one Asian institution.
In an effort to determine the clinical implications of idiopathic erythema, Dr. Steven Thng and colleagues at the National Skin Center in Singapore reviewed the records of patients evaluated for erythema from 2001 to 2005 and compared those patients with published cases series as well as with data from the Singapore Cancer Registry.
Dr. Thng and colleagues identified 218 patients evaluated for erythema during the study period—108 cases (50%) were classified as idiopathic. Among patients with an identified cause of erythema, preexisting dermatoses (30%) and drug reaction (15%) were the most common diagnoses.
On follow-up, the researchers found idiopathic erythema was associated with visceral malignancy in 18% of patients and with cutaneous T-cell lymphoma in 5%.
“We recommend close follow-up with re-evaluation for malignancy even if the initial investigation had been negative,” they said in a poster at the International Congress of Dermatology.
Few investigators have attempted to examine the natural history and potential clinical consequences of unexplained erythema, the researchers wrote. Moreover, previous studies primarily involved white populations.
Most patients with idiopathic erythema were men (73%) and idiopathic erythema tended to occur at an older age (69 years) when compared with erythema of known cause (62 years). Patients with idiopathic erythema tended to experience a slow onset of disease and an average duration of 22 days. They also experienced more episodes of disease (average of 1.75 episodes), compared with patients who had erythema of known cause (average of 1.32 episodes).
When compared with age-standardized cases, patients with idiopathic erythema had more than a threefold greater risk of visceral malignancy. Dr. Thng and colleagues reported no disclosures.