Overview
Metastatic adenocarcinoma to the skin represents the spread of cancer originating in glandular tissue to the skin. This is a rare manifestation of advanced adenocarcinoma from various primary sites.
Diagnosis
Diagnosis is typically made via skin biopsy and histopathological examination 1.
Immunohistochemical staining is crucial to determine the primary site of origin 1.Management
Treatment strategies for cutaneous metastases of adenocarcinoma are generally guided by the management of the primary cancer 1.
Systemic therapies, including chemotherapy and targeted agents, are often employed 1.
Specific systemic treatments like deucravacitinib have been evaluated for moderate to severe plaque psoriasis, showing efficacy compared to placebo and apremilast 1. Comparative efficacy of systemic therapies may differ between Asian and White patients 1.Special Populations
No specific information regarding special populations (pregnancy, pediatrics, elderly, comorbidities) was found in the provided abstracts.Key Recommendations
Skin biopsy with histopathological examination and immunohistochemistry is recommended for the diagnosis and determination of the primary site of metastatic adenocarcinoma to the skin 1. (Evidence: Moderate)
Systemic therapies, guided by the management of the primary adenocarcinoma, are the mainstay of treatment for metastatic adenocarcinoma to the skin 1. (Evidence: Moderate)
For patients with moderate to severe plaque psoriasis, deucravacitinib demonstrates comparative efficacy to placebo and apremilast, with similar efficacy to other biologic agents like adalimumab, infliximab, and ustekinumab in Asian populations 1. (Evidence: Strong)References
1 Tsai TF, Tada Y, Kung C, Zhong Y, Cichewicz A, Borkowska K et al.. Indirect comparison of deucravacitinib and other systemic treatments for moderate to severe plaque psoriasis in Asian populations: A systematic literature review and network meta-analysis. The Journal of dermatology 2024. link