PARANEOPLASTIC PRURITUS ASSOCIATED WITH PRESENTED LUNG CANCER: CASE REPORT

ABSTRACT
Pruritus, defined as an unpleasant sensation that compels scratching, is a common occurrence in dermatological disorders. Chronic pruritus is defined as itching that persists for a period exceeding six weeks. Lichen simplex chronicus (LSC) is a chronic dermatological condition that presents with dry, scaly, and thickened skin lesions, which typically arise from habitual scratching. Additionally, paraneoplastic pruritus may serve as an early indicator of the presence of solid tumours. This case report outlines the diagnostic and therapeutic process of a 73-year-old male diagnosed with lichen simplex chronicus (LSC), confirmed by skin biopsy. Subsequent malignancy screening revealed the presence of solid nodules in the lungs and multiple metastatic masses in the liver. Biopsies of the lung nodule and liver mass demonstrated positivity for T TF-1 and synaptophysin, leading to a diagnosis of mixed component lung adenocarcinoma and small cell lung cancer. In order to ascertain the underlying cause of the patient's chronic itching, a comprehensive investigation was conducted, which considered a range of potential factors, including haematological diseases, endocrine disorders, liver diseases, infections, drug-related factors, and neurological and psychiatric causes. Despite a comprehensive evaluation, the precise etiology of the chronic itching remained elusive. The initiation of carboplatin and etoposide therapy for lung cancer resulted in a significant reduction in the patient's itching, which may suggest a possible link between chronic itching and malignancy. Unfortunately, the patient succumbed to hypoxia, pneumonia, and multiple organ failure two months post-diagnosis. This case serves to illustrate the potential of chronic pruritus as a symptom of cancer. While paraneoplastic pruritus is often associated with haematological malignancies, this report highlights that it can also occur with solid tumours. It is important for clinicians to be aware of this potential association, as it allows for timely diagnosis and treatment.
Keywords: Pruritus, lichen simplex chronicus, paraneoplastic, carcinoma