Erythroderma-as a paraneoplastic phenomenon of ovarian adenocarcinoma

Abstract

About 1% of erythroderma cases have a neoplastic or paraneoplastic etiology. But erythroderma secondary to adenocarcinoma of ovary has not yet been reported in the scientific literature to best of our knowledge. A 54-year-old female patient presented to OPD with complaints of reddish itchy scaly lesions over body since 2 months. Based on history and examination, contact dermatitis was considered as provisional diagnosis. Patient was started on prednisolone, cyclosporine and topical corticosteroids which led to partial improvement of the skin lesions. But the lesions recurred and involved almost entire body surface area after 15 days of stopping the medications by the patient. This instigated further evaluation of the patient. All routine lab investigations were within normal limits. Skin biopsy showed mixed inflammatory infiltrate. USG abdo-pelvis detected right ovarian mass. Serum CA 125 was found to be raised. This leads to the suspicion of internal malignancy. Staging laparotomy was done. Tissue biopsy revealed high grade serous papillary cyst adenocarcinoma of right ovary. Thus, final diagnosis of paraneoplastic erythroderma secondary to ovarian adenocarcinoma was made. Patient responded well to corticosteroids after total abdominal hysterosalphingo-oophorectomy and chemotherapy in due course of time of 4 months. Hence, we conclude, erythroderma patients with unclear etiologies should be thoroughly evaluated. This will lead to timely diagnosis and treatment leading to better prognosis.