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Spontaneous Disappearance Of Psoriasis As Presenting Feature Of Oat-cell Carcinoma Of Lung

Lennard & Lennard, 6253Lung cancer

British Medical Journal 281(6253): Nov 29 1980; 1460

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Abstract

A case is presented in which the patient showed clear evidence of ectopic adrenocorticotrophic hormone syndrome secondary to oat-cell carcinoma of lung. In association with this and as an initial feature she had a spontaneous cure of lifelong psoriasis. The authors think that these two events were related and can find no other reports of this unusual phenomenon. The patient was aware of her diagnosis but declined further treatment.

Case Details

Personal Characteristics

68-year-old woman, lifelong and extensive psoriasis, smoked 20 cigarettes a day all her adult life, looked cushingoid

Clinical Characteristics

Spontaneous cure of lifelong psoriasis, episode of haemoptysis, collapse of the right lower lobe, enlargement of the liver, friable tumour in the right main bronchus, glycosuria, fasting blood glucose concentration of 10 mmoles /l, normal full blood count, erythrocyte sedimentation rate 16 millimeters in first hour, hypokalaemic alkalosis, raised twenty-four hour urinary free cortisol concentrations, lost diurnal rhythm, serum adrenocorticotrophic hormone concentration was 334 nanograms/l, liver alkaline phosphatase activity was 530 iu/l, multiple filling defects in liver

Remission Characteristics

Spontaneous cure of lifelong psoriasis

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Radiography, bronchoscopy, biopsy, blood count, measurement of urea and electrolyte concentrations, twenty-four hour urinary free cortisol concentrations, plasma cortisol concentrations, serum adrenocorticotrophic hormone concentration, liver scan

Additional Notes

The patient was aware of her diagnosis but declined further treatment and was discharged home.