Digital Papillary Carcinoma of Skin

Digital Papillary Carcinoma of Skin

Article
Skin Care
Diseases & Conditions
+1
Contributed byLester Fahrner, MD+1 moreJun 01, 2021

What are the other Names for this Condition? (Also known as/Synonyms)

  • Cutaneous Digital Papillary Carcinoma
  • Digital Papillary Adenocarcinoma of Skin

What is Digital Papillary Carcinoma of Skin? (Definition/Background Information)

  • Digital Papillary Carcinoma of Skin is an uncommon malignant tumor. It is an aggressive tumor that frequently infiltrates local tissues and bones. It is also known to recur (following treatment) and metastasize
  • The tumor is typically observed in middle-aged and older adults. Digital Papillary Carcinoma of Skin is normally painful and treatment is regularly sought because of the pain it causes
  • This slow-growing tumor occurs frequently on the digits (fingers and toes), but can occur at other sites on the body too
  • The risk factors and cause of Digital Papillary Carcinoma of Skin are generally unknown
  • The treatment of choice is a surgical excision with clear margins followed by radiation therapy and/or chemotherapy, as decided by the healthcare provider
  • In majority of the cases, the prognosis is good with appropriate early treatment. However, the prognosis of Digital Papillary Carcinoma of Skin also depends upon the stage of the tumor, health status of the individual, and whether it has metastasized

Who gets Digital Papillary Carcinoma of Skin? (Age and Sex Distribution)

  • Digital Papillary Carcinoma of Skin is an infrequently occurring tumor that can affect adults in a age range of 40-70 years (average age of presentation being 55 years)
  • Both males and females are affected, though the condition is more common in males than females 
  • There is no predilection for any racial or ethnic group

What are the Risk Factors for Digital Papillary Carcinoma of Skin? (Predisposing Factors)

  • Currently, the risk factors for Digital Papillary Carcinoma of Skin are not well-established

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Digital Papillary Carcinoma of Skin? (Etiology)

  • The cause of development of Digital Papillary Carcinoma of Skin is not well-understood
  • Genetic mutations have been suspected by researchers in some cases, but these have not been well-characterized

What are the Signs and Symptoms of Digital Papillary Carcinoma of Skin?

Digital Papillary Carcinoma of Skin may present the following signs and symptoms:

  • It is typically seen as a solitary tumor that can vary in size from 1-5 cm
  • There may be severe pain at the site of the tumor
  • The tumor usually grows slowly
  • The skin lesion may ulcerate, which can cause pain at the site
  • It is a malignant tumor that is mostly present on the hands and feet (mostly the digits are affected), but it can be present on the palms and soles too
  • The tumor can occur at other locations too

How is Digital Papillary Carcinoma of Skin Diagnosed?

A diagnosis of Digital Papillary Carcinoma of Skin may involve the following:

  • A thorough medical history and physical examination
  • Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
  • X-ray of affected region is an important diagnostic tool to determine the severity of infiltration
  • Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Digital Papillary Carcinoma of Skin?

Digital Papillary Carcinoma of Skin is a rare and aggressive tumor that is commonly known to recur after its surgical excision (in almost 50% of the cases). The other complications include:

  • It can infiltrate into the underlying bone, nerve, muscle, or joint. Due to this, there can be restricted movement in the joint or limb (or digit)
  • Metastasis is known to occur in 1 in 7 cases (about 15%); metastasis can occur to the local lymph nodes and lungs
  • Ulceration of the tumor can lead to secondary infections of bacteria and fungus
  • Some individuals may have concerns regarding their cosmetic appearance
  • Side effects of chemotherapy (such as toxicity) and radiation

How is Digital Papillary Carcinoma of Skin Treated?

The treatment of Digital Papillary Carcinoma of Skin may involve the following:

  • In most cases, a wide surgical excision and removal of the entire tumor is the preferred treatment option. This may be followed by radiation therapy and/or chemotherapy
  • If the tumor has metastasized, then a combination of chemotherapy, radiation therapy, and invasive procedures may be used to treat the tumor
  • Follow-up care with regular screening and check-ups are important and encouraged

How can Digital Papillary Carcinoma of Skin be Prevented?

  • Currently, there are no known methods to prevent Digital Papillary Carcinoma of Skin occurrence
  • Regular medical screening at periodic intervals with blood tests, scans, and physical examinations, are mandatory, due to its metastasizing potential and high possibility of recurrence. Often several years of active vigilance is necessary

What is the Prognosis of Digital Papillary Carcinoma of Skin? (Outcomes/Resolutions)

  • Digital Papillary Carcinoma of Skin is a malignant tumor and its prognosis depends upon a set of several factors, which include:
    • Stage of tumor: With lower-stage tumors, when the tumor is confined to site of origin, the prognosis is usually excellent with appropriate therapy. In higher-stage tumors, such as tumors with metastasis, the prognosis is poor
    • The surgical resectability of the tumor (meaning if the tumor can be removed completely)
    • Overall health of the individual: Individuals with overall excellent health have better prognosis compared to those with poor health
    • Age of the individual: Older individuals generally have poorer prognosis than younger individuals
    • Whether the tumor is occurring for the first time, or is a recurrent tumor. Recurring tumors have a poorer prognosis compared to tumors that do not recur
    • Response to treatment: Tumors that respond to treatment have better prognosis compared to tumors that do not respond so well to treatment
  • An early diagnosis and prompt treatment of the tumor generally yields better outcomes than a late diagnosis and delayed treatment
  • If metastasis (such as to the local lymph nodes) is observed, then the prognosis is unpredictable
  • Recurrence of the tumor on its incomplete removal is high at about 50%
  • Regular follow up visits with the healthcare provider are important

Additional and Relevant Useful Information for Digital Papillary Carcinoma of Skin:

  • This tumor used to be known as ‘Aggressive Digital Papillary Adenoma’; but currently, this term is no longer in use
  • There is no evidence to prove that Cutaneous Digital Papillary Carcinoma formation is influenced by one’s dietary choices
  • Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
  • The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse
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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Lester Fahrner, MD picture
Reviewed by

Lester Fahrner, MD

Chief Medical Officer, DoveMed Team

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