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Year : 2020  |  Volume : 18  |  Issue : 4  |  Page : 338-339

Not just skin-deep!

1 Department of Dermatology, Bangalore Baptist Hospital, Bengaluru, Karnataka, India
2 Department of Oncology, Bangalore Baptist Hospital, Bengaluru, Karnataka, India

Date of Submission27-Mar-2020
Date of Decision30-Apr-2020
Date of Acceptance28-May-2020
Date of Web Publication19-Oct-2020

Correspondence Address:
Dr. Priya Jeevamani Chandrasekaran
Department of Dermatology, Bangalore Baptist Hospital, Bengaluru - 560 024, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cmi.cmi_45_20

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How to cite this article:
Chandrasekaran PJ, Mathew S. Not just skin-deep!. Curr Med Issues 2020;18:338-9

How to cite this URL:
Chandrasekaran PJ, Mathew S. Not just skin-deep!. Curr Med Issues [serial online] 2020 [cited 2022 Aug 9];18:338-9. Available from: https://www.cmijournal.org/text.asp?2020/18/4/338/298593

  Case Scenario Top

A 50-year-old woman presented with mucocutaneous lesions as shown in [Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d. These lesions were present since childhood and were asymptomatic. She had been diagnosed to have carcinoma right breast and had undergone mastectomy and chemotherapy 3 years back. Her colonoscopy showed multiple polyps in the sigmoid colon and rectum. Her daughter aged 25 years who had accompanied her was noted to have lesions as shown in [Figure 2]a, [Figure 2]b, [Figure 2]c. She was noted to have a lump over the neck and a surgical scar [Figure 2]d.
Figure 1: Index case (a) papules over tongue, (b) skin colored papules around the nostrils (red arrows), (c,d) hyperkeratotic papules

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Figure 2: Daughter -(a) papules over tongue, (b) skin colored papules along right ear (red arrow), (c) hyperkeratotic papules (red arrows), (d) lump over neck and surgical scar

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  Questions Top

  1. What is your diagnosis?
  2. What are the mucocutaneous lesions shown here?

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Conflicts of interest

There are no conflicts of interest.

  References Top

Nosé V. Genodermatosis affecting the skin and mucosa of the head and neck: Clinicopathologic, genetic, and molecular aspect – PTEN-hamartoma tumor syndrome/Cowden syndrome. Head Neck Pathol 2016;10:131-8.  Back to cited text no. 1
Cavaillé M, Ponelle-Chachuat F, Uhrhammer N, Viala S, Gay-Bellile M, Privat M, et al. Early onset multiple primary tumors in atypical presentation of Cowden syndrome identified by whole-exome-sequencing. Front Genet 2018;9:353.  Back to cited text no. 2
Byrd V, Getz T, Padmanabhan R, Arora H, Eng C. The microbiome in PTEN hamartoma tumor syndrome. Endocr Relat Cancer 2018;25:233-43.  Back to cited text no. 3
National Comprehensive Cancer Network. Genetic/Familial High Risk Assessment. Breast and Ovarian v. 1. 2010. Available from: http://www.jnccn.org/content/8/5/562.full.pdf+html. [Last accessed on 2020 Apr 30].  Back to cited text no. 4
Smerdel MP, Skytte AB, Jelsig AM, Ebbehøj E, Stochholm K. Revised Danish guidelines for the cancer surveillance of patients with Cowden Syndrome. Eur J Med Genet 2020;63:103873.  Back to cited text no. 5
Pilarski R, Burt R, Kohlman W, Pho L, Shannon KM, Swisher E. Cowden syndrome and the PTEN hamartoma tumor syndrome: Systematic review and revised diagnostic criteria. J Natl Cancer Inst 2013;105:1607-16.  Back to cited text no. 6


  [Figure 1], [Figure 2]

  [Table 1]


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