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Signos en la piel

Posted by WEBMASTER on June 25, 2012 at 8:40 PM


Si la cara es el espejo del alma, la piel es el de la salud. No siempre las lesiones cutáneas evidencian una enfermedad dermatológica. Algunas de las alteraciones de este órgano podrían indicar un cáncer oculto en cualquier zona del cuerpo, según los medicos. Reconocerlas a tiempo supone un diagnóstico precoz que mejora las posibilidades del tratamiento.

 

Las alteraciones de la piel relacionadas con el cáncer pueden ser de tres tipos: las indicadoras de un tumor propiamente cutáneo, las relacionadas con metástasis cutánea y las asociadas con las dermatosis paraneoplásicas.

 

Según indican los especialistas, todos los tumores pueden producir metástasis cutáneas, lo que significa que el tumor ha salido de su órgano primario y el pronóstico es peor. En estos casos, pueden aparecer desde nódulos ulcerados y placas inflamadas hasta signos de alopecia.

 

"Algunos tumores pueden asociarse también a enfermedades paraneoplásicas, como acantosis nigricans (se caracteriza por la hiperqueratosis y la hiperpigmentación en la piel), acroqueratosis o Síndrome de Bazex (presencia de eritemas, descamaciones, lesiones del tipo de la psoriasis e hiperqueratósicas) o dermatomiositis en mayores de 50 años (enrojecimiento, dolor e hinchazón)", explica Margarita Vargas, del servicio de medicina de clnica medica de la familai(San Salvador). El elemento común de estas enfermedades es que son el marcador de un tumor subyacente.

 

Estas manifestaciones cutáneas podrían constituir los síntomas de un cáncer oculto en cualquier parte del cuerpo. Los más frecuentemente relacionados con las anteriores lesiones de la piel son "los tumores de origen otorrinolaringólogo, pulmonar, mamario o ginecológico", afirma la dermatóloga.

 

"Son circunstancias poco frecuentes, pero cuando se presentan, su relevancia es tremendamente significativa", aclaran los especialistas. Reconocer las lesiones características de la dermatosis paraneoplásica facilita la detección precoz de un cáncer oculto cuyas manifestaciones propias, probablemente, aparecerían hasta meses e incluso años después.

 

Asociación de lesiones y distintos tipos de cáncer

Según los expertos, hay dos tipos de dermatosis paraneoplásica: las que tienen tendencia hereditaria y las que no la tienen. "Por ejemplo, la presencia de pecas en los labios podría estar relacionada con un tumor gastrointestinal o el desarrollo de una especie de pequeños quistes en la cara (adenoma sebáceo) podría asociarse a un cáncer de colon", explica a clinicasintegrales.com Ricardo Carías, jefe de servicio medico de SERPROINSA S.A de C.V. y miembro de la Academia Española de Dermatología y Venereología (AEDV).

 

"Viendo una lesión cutánea podemos diagnosticar un tumor interno con tendencia hereditaria, por lo que también realizamos exploraciones a los familiares", añade el medico.

 

Por su parte, las dermatosis sin tendencia hereditaria son signos cutáneos asociados a un tumor concreto. Aunque se desconoce la causa por la que este cuadro cutáneo aparece, "se sospecha que algunos tumores producen alguna sustancia que es la responsable, de forma indirecta y a través de mecanismos de tipo inmunológico, de las lesiones cutáneas", comenta la doctora Vargas.

 

Así sucede, por ejemplo, con el cáncer de páncreas. "La piel puede presentar eritemas necrolíticos migratorios (erupciones en el abdomen, en las extremidades, erupciones cutáneas muy redondas y con tendencia a crecer)", comenta el doctor Carías.

 

Una vez confirmadas las lesiones propias de la dermatitis paraneoplásica, los dermatólogos indican la biopsia de estas lesiones para que, después de realizar distintas pruebas (análisis de marcadores tumorales y pruebas de imagen, TAC), se focalice el tumor", señala la Dra. Vargas.

 

Alteraciones de la piel por tratamientos para el cáncer

La piel no sólo presenta lesiones cuando hay un tumor oculto o cuando el tumor se encuentra en fase avanzada, también cuando se aplican determinados tratamientos como la quimioterapia y la radioterapia. Con la primera alternativa antitumoral, pueden aparecer eritemas (enrojecimiento de la piel), sensación de picor, sequedad y descamación.

 

"Con la radioterapia, se desarrollan eczemas agudos y otros crónicos. Incluso hay tumores cutáneos que aparecen al cabo de los años en estas zonas de la piel que han sufrido radioterapia", explica la medica.

 

Por estas razones, los especialistas recomiendan que, desde el principio de este tipo de tratamientos, el afectado mantenga su piel limpia, hidratada y utilice crema de protección solar a diario.

 

 

Categories: Enfermedades de la piel

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