Unexplained erythema could be malignancy.(NEWS)

PRAGUE -- Unexplained erythema should raise suspicion about a possible underlying malignancy, according to a review of cases at 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 records of patients evaluated for erythema and compared them with published case series as well as Singapore Cancer Registry data.

Dr. Thng and colleagues identified 218 patients evaluated for erythema during the study period--108 cases (50%) were classified as idiopathic. On follow-up, they found idiopathic erythema was associated with visceral malignancy in 18% 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," Dr. Thng reported in a poster presented at the International Congress of Dermatology. 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 also experienced more episodes of disease (average of 1.75 episodes) than patients with erythema of known cause (1.32 episodes).

Compared with cases in the cancer registry, patients with idiopathic erythema had more than a threefold greater risk of visceral malignancy. Dr. Thng and colleagues noted that the findings of their study came from a review of Asian patients and therefore may not be applicable in other regions. They had no relevant disclosures.

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