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There is a well-established relationship between vasculitides and malignancy. The most common type of cutaneous vasculitis associated with both hematologic and solid organ malignancy is leukocytoclastic vasculitis, a small-vessel vasculitis.1, 2, 3, 4 Other systemic vasculitides with cutaneous manifestations seen in association with malignancy include systemic polyarteritis nodosa (PAN) and the antineutrophil cytoplasmic antibody-associated vasculitides, including microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis.3 Cutaneous polyarteritis nodosa (cPAN), a rare variant of systemic PAN, is a skin-limited small-to-medium vessel vasculitis affecting patients of all ages.5 Clinically, cPAN and systemic PAN present similarly with initial cutaneous findings of livedo reticularis and tender subcutaneous nodules, which are most commonly found on the lower extremities.5 Cutaneous ulceration and retiform purpura may also be seen in both conditions. Cutaneous PAN is not commonly associated with malignancy. We present a case of cPAN developing in the context of underlying chronic myelogenous leukemia (CML) and resolving with treatment for CML, supportive of a paraneoplastic presentation of cPAN.

Systemic sclerosis (SSc) is an idiopathic sclerosing condition that may affect both the skin and internal organs.1 Although SSc has been associated with an increase in the development of malignant neoplasms, the disease can present in a paraneoplastic manner months to years after initial cancer diagnosis in rare cases.1,2 Malignant acanthosis nigricans is a rare paraneoplastic skin syndrome that presents with sudden onset of hyperpigmented velvety plaques, most commonly in intertriginous areas. Here, we report a case of newly acquired SSc and acanthosis nigricans in a patient with a 2-year history of gastric adenocarcinoma being treated with capecitabine.

Cutaneous T-cell lymphoma is a malignant non-Hodgkin T-cell lymphoma, with mycosis fungoides (MF) and Sezary syndrome being the most common subtypes. In patients with MF, transformation to large cell histology is associated with worse prognosis. Paraneoplastic scleroderma has been reported arising within the context of lung, breast, and hematologic malignancies,1 but its association with T-cell lymphomas is exceedingly rare.2, 3, 4, 5 We present the case of a woman with MF with CD30+ large cell transformation who also had the progressive sclerodermoid skin changes of paraneoplastic scleroderma.

Dermatomyositis is a rare autoimmune disease characterized by skin inflammation and muscle weakness with an incidence between 0.5 and 1 cases per 100 000 individuals per year, the majority being women in the fifth or sixth decade of life.1 Characteristic skin findings include violaceous and poikilodermatous patches, Gottron sign, Gottron papules, heliotrope sign, periorbital edema, and periungual telangiectasias. The diagnosis of dermatomyositis is associated with an increased risk of malignancy, particularly within 1 year of symptom onset.2 The majority of these malignancies are aerorespiratory or gynecologic in origin.2 Here, we describe a patient with paraneoplastic dermatomyositis associated with chondrosarcoma of the humerus.

Erythema gyratum repens (EGR), considered one of the most specific cutaneous paraneoplastic phenomena, is characterized by a serpiginous morphology and a migrating scaly border. EGR is associated with malignancy, most commonly bronchial, esophageal, and breast, in more than 80% of cases.1, 2 Here we report 2 cases of patients with pityriasis rubra pilaris (PRP), whose eruption transformed to an EGR-like eruption without any evidence of malignancy.

Cutaneous small-vessel vasculitis (CSVV) is a vasculitis of small vessels that classically presents with purpuric papules on the lower extremities. It may occur in the setting of several triggers such as infection, drug exposure, and collagen vascular disease.1 Of all cases of CSVV, fewer than 5% are thought to be paraneoplastic.2 Most of these cases are associated with hematologic malignancies (90%), whereas the remainder are associated with solid organ malignancies (10%).3 We present a rare case of paraneoplastic CSVV that specifically occurred in the setting of recurrent metastatic breast cancer.

Thymoma is the most common neoplasm of the thymus, and early-stage tumors carry an excellent prognosis with 5-year survival rates over 85% with primarily surgical management.1 However, thymoma has a strong association with paraneoplastic syndromes, which do not have the same favorable response to surgery. Paraneoplastic syndromes are found to persist, worsen, or even present in the post-thymectomy setting. We report a case of likely paraneoplastic vasculitis in the setting of thymoma that presented after thymectomy.