Dermatologic Manifestations of Metastatic Carcinomas Treatment & Management

Updated: Jul 07, 2022
  • Author: Thomas N Helm, MD; Chief Editor: Dirk M Elston, MD  more...
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Palliative Treatment

Effective treatment depends on treatment of the underlying tumor. Palliative care is given if lesions are asymptomatic and the primary cancer is untreatable. This care includes keeping lesions clean and dry and debriding the lesions if they are bleeding or crusted. Hydrocolloid dressings may be used to help prevent secondary infection.Topical retinoids offer promise in select cases, and studies indicate that the immune modulator imiquimod 5% cream (Aldara) may lead to regression of metastases in some patients with melanoma. Photodynamic therapy also may be useful for palliation of skin metastases.

Short-wavelength radiation therapy may be helpful for providing symptomatic relief from painful lesions, using superficial electron beam therapy. Carbon dioxide laser therapy, [16, 17] electrochemotherapy, [18] liquid nitrogen cryotherapy with temperature probe control, and other treatment approaches may also be of value.

Pulsed dye laser treatment, which can reduce blood flow to highly vascularized lesions, may be of value. Intralesional chemotherapy and cytokines can also be helpful.

Medical camouflage with cosmetics (eg, Dermablend) may be of value to disguise visible metastases for cosmetic purposes.


Surgical Care

In many cases, cutaneous metastases can cause disfigurement or social embarrassment, or they can diminish the quality of the patient's life. Surgical approaches are generally the most effective as a temporizing measure for cutaneous metastases. Excision and removal of metastases may be warranted to enhance the patient's quality of life, but excision of select metastases does little to increase survival. Simple excision is usually the treatment of choice.