Snapshot A 54-year-old man presents to the clinic with complaints of unintentional weight loss over the past year. He reports losing about 20 lbs. without any significant changes to his diet or exercise routine. He also noticed a rash that developed over the past week on his right hand. A physical examination reveals an erythematous plaque involving the palmar aspect of his right hand. He denies any recent contacts, outdoor activities, changes to his detergents or lotions. Introduction Overview login to view 1 more bullet Epidemiology Incidence login to view 2 more bullets Demographics login to view 1 more bullet Risk factors login to view 1 more bullet ETIOLOGY Pathogenesis login to view 4 more bullets Associated conditions login to view 2 more bullets Presentation Symptoms login to view 7 more bullets Physical exam login to view 1 more bullet Studies Serum labs login to view 2 more bullets Skin biopsy login to view 3 more bullets Differential Pemphigus foliaceus login to view 3 more bullets Pellagra login to view 2 more bullets Treatment Medical treatment login to view 2 more bullets Surgical and interventional login to view 5 more bullets Complications Metastasis login to view 1 more bullet Deep vein thrombosis and pulmonary embolism Anemia Reversible dilated cardiomyopathy Prognosis Slow growing but the majority of cases are metastatic at diagnosis Poor prognosis among patients with metastatic disease login to view 1 more bullet