Hyperpigmentation means that some parts of your skin appear darker than your natural color. This can look like flat brown, black, pink, or red spots or patches.
It can occur in a type of lung cancer called small cell lung cancer (SCLC). SCLC is the less common type of lung cancer, accounting for about
Skin changes in SCLC may be due to a secondary condition called ectopic adrenocorticotropic hormone (ACTH) syndrome. Ectopic ACTH syndrome (EAS) is estimated to occur in 2 to 5 percent of people with SCLC.
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In SCLC, these changes can occur in the nerve cells or hormone-producing (endocrine) cells found throughout your lungs. This is why SCLC is often considered a type of neuroendocrine carcinoma. The term “neuroendocrine” refers to the connections between the endocrine and nervous systems.
Cells from a tumor often release hormones into the blood in response to stimulation of the nervous system. Neuroendocrine tumors may produce excessive amounts of ACTH.
Your body releases ACTH to help regulate levels of the hormone cortisol. Cortisol is the primary stress hormone. It regulates how the body turns food into energy, controls blood pressure and blood glucose levels, and affects how the body responds to stress.
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Among other symptoms, too much ACTH can cause your skin to become discolored. According to 2019 research, this happens because ACTH causes certain skin cells, called melanocytes, to produce melanin. Melanin is responsible for the pigmentation of your skin.
Secondary disorders like EAS that occur from neuroendocrine tumors are known as paraneoplastic syndromes. They may be related to an atypical response from the immune system to the tumor.
It’s very rare for hyperpigmentation to occur in people with NSCLC because this cancer doesn’t come from neuroendocrine cells. However, there has been at least one
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There have also been a few reported cases of a condition known as acanthosis nigricans in people with NSCLC, including squamous cell lung cancer and adenocarcinoma, according to a
If the cancer is still in its early stages, your doctor might recommend surgery to remove (resect) the tumor. Your doctor may also recommend chemotherapy or a combination of different chemotherapies.
Medications, such as steroids, may be prescribed to reduce ACTH levels. Your doctor may also prescribe ketoconazole or mitotane to lower your cortisol level, per a 2020 research review.
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EAS associated with SCLC is difficult to diagnose and tends to be more aggressive. This condition does not respond as well to treatments and people who have it may be more likely to get infections. For these reasons, the outlook is often poor.
Early detection is important with SCLC and EAS. Early detection may improve outlook by leading to tumor removal or medication to manage ACTH levels. As a result, early detection and treatment for this syndrome might improve survival rates.
EAS can lead to a condition known as ectopic Cushing’s syndrome (ECS). Cushing’s syndrome happens when cortisol levels remain high for a long time.
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Dark spots on the skin are very unlikely to be a sign you have lung cancer. Even if lung cancer spreads (metastasizes) to the skin, these skin metastases will usually appear as nodules, not hyperpigmentation.
Dark spots on your skin in the absence of other symptoms can have many sources, and most aren’t a cause for concern. Sun exposure and certain medications can result in hyperpigmentation.
If you have concerns about dark spots on your skin or you’re experiencing other symptoms along with hyperpigmentation, be sure to plan a visit with a doctor or dermatologist.
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Skin discoloration can occur roughly 2 to 3 weeks after chemotherapy treatment begins. The spots typically go away a few months after the chemo is over as new skin cells replace the old ones.
Other treatments for lung cancer, such as immunotherapy and targeted therapies, can also cause severe skin rashes, dryness, and hyperpigmentation, according to a
. In at least one case report yet to be peer-reviewed, an immunotherapy medication used to treat NSCLC, known as pembrolizumab (Keytruda), caused spots on the skin.
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You can help prevent your risk of lung cancer in general by avoiding smoking and secondhand smoke. If you already smoke, quitting can greatly reduce your risk of lung cancer.
Lung cancer, particularly SCLC, can result in skin discoloration in rare cases. This is due to a secondary condition known as EAS. SCLC with EAS has a poor outlook.
If you have received a lung cancer diagnosis and notice any atypical skin changes, it’s important to see your doctor right away.
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Has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Many people with lung cancer experience skin rashes as side effects from treatments such as radiation, chemotherapy, targeted therapy, immunotherapy, or stem cell transplantation. Different kinds of skin reactions can occur, depending on the specific treatment. Rashes may be managed both in a clinical setting and at home.
Members have shared their experiences with rashes and lung cancer treatment. “I have a rash from chemo that kind of burns like a bad sunburn, ” a member said. Another member responded, “I just got a rash from the chemo, too … just on my head and neck. Itches like crazy! It’s annoying, but nothing I can’t deal with.”
A third member wrote, “I have just been on immunotherapy every four weeks. I have been very lucky in that I only experience fatigue and, every once in a while, a rash.”
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It’s important to recognize which type of rashes are common and can be treated at home and when they’re severe and require medical care. In some cases, urgent medical treatment may be needed for serious rashes.
Various treatment options for lung cancer can affect the skin in a variety of ways. Be sure to talk to your oncologist before treatment to discuss potential skin rashes.
As many as 95 percent of people who undergo radiation, also known as radiotherapy, experience changes in their skin, known as radiation dermatitis. Radiation exposure can cause inflammation at the site of treatment due to reactions in skin tissue and the skin barrier.
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Radiation dermatitis that appears within 24 hours of treatment is usually caused by a dilation (narrowing) in blood vessels in the skin and often goes away in a few days. More sustained reactions may occur if exposure to radiation has affected hair follicles and deeper layers of the skin. Acute reactions may appear weeks or months after treatment due to higher doses of radiation that cause deeper skin injuries.
In rare cases, chronic radiation dermatitis may develop months or years after treatment when skin tissue does not heal. Skin folds can increase the risk for acute reactions because they trap moisture, which can absorb more radiation.
More than 90 percent of people who have chemotherapy for non-small cell lung cancer with newer targeted therapy drugs experience extensive skin dryness. Targeted therapy increases the risk for skin reactions, such as follicular rash (in hair follicles), itching, pain, and infection. Follicular rash is also known as acneiform rash and resembles acne.
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Acneiform rash from targeted therapy is caused by an inflammatory response to chemotherapy drugs that target the epidermal growth factor receptor, which can cause an overproduction of cells that are associated with cancerous tumors. Around 8 percent to 12 percent of cases are severe.
Having radiation therapy prior to some standard chemotherapy or targeted therapy drugs is a risk factor for a condition called radiation recall, which can resemble radiation dermatitis. Radiation recall occurs in approximately 9 percent of cases and may cause skin reactions that range from mild to severe.
Immunotherapy drugs work by activating the immune system to target cancer cells. Side effects occur when these drugs cause the immune system to attack healthy cells. Rashes and itching are the most common side effects in skin. Mouth sores and hair loss can also occur.
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Rashes that occur after a stem cell transplant can be an indication of acute graft-versus-host disease, a potentially serious complication in which donor cells attack host cells, which can first show up in the skin.
Rashes after a stem cell transplant can also be due to a viral infection, which occurs in 60 percent to 70 percent of cases. Additionally, skin rashes may occur due to side effects from drugs that are used in the treatment of people who have had a stem cell transplant.
If you develop a rash after treatment for lung cancer, be sure to discuss the symptoms with your oncology team and determine if you need to see a dermatologist. There are several common types of rash that commonly occur with treatment. Severe symptoms are an indication that immediate medical care is needed, particularly if the eyes or mucous membranes (e.g., mouth, eyelids, nose) become affected.
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Symptoms from radiation dermatitis typically occur in the area of the body where radiation treatment has occurred. Mild to moderate symptoms include:
This instance of radiation dermatitis in a person’s armpit was caused by radiation therapy for breast cancer. Symptoms of this type of rash include discoloration and peeling. (Medical Images)
More serious symptoms include moist peeling of skin outside of folds, easy or
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