Lung Cancer Symptoms on the Skin to Watch For

Skin symptoms can be an unexpected sign of lung cancer. With most types of lung cancer, people don't show signs until it has spread. But lung cancer can also cause other syndromes that can lead to additional problems seen on the skin.

This article will discuss how lung cancer can affect the skin, symptoms to look for, and skin changes that may occur during treatment for lung cancer.

How Lung Cancer May Affect the Skin

Lung cancer that has spread to another organ or has caused a syndrome, such as the following, may lead to symptoms that appear on the skin.

Horner Syndrome

Horner syndrome can be caused by a Pancoast tumor, a type of tumor that develops in the top part of the lung. Because of the location of this type of tumor, it can put pressure on a group of nerves that runs from the upper chest into your neck and arms (called the brachial plexus). The pressure on the brachial plexus may lead to Horner syndrome.

Symptoms of Horner syndrome affect just one side of the face and include:

• Flushed skin 
• An inability to sweat
• A smaller (constricted) pupil 
• A drooping or weak eyelid

Superior Vena Cava Syndrome

Superior vena cava syndrome can be caused by lung cancers in the upper right lung and lymph nodes inside the chest. The superior vena cava is a major vein that carries blood from your head, neck, upper chest, and arms to the heart.

If a tumor compresses this vein, it can lead to symptoms such as difficulty breathing, shortness of breath, coughing, and swelling of your face, neck, upper body, and arms.

Paraneoplastic Syndromes

Paraneoplastic syndromes are caused by lung cancer tumors that secrete certain hormone-like substances. Symptoms that arise from these syndromes may be the first signs of lung cancer.

There are many types of paraneoplastic syndromes, but the most common ones associated with lung cancer that may also have skin symptoms include:

• Cushing's syndrome: The cancer cells can make a hormone that causes the adrenal glands to produce cortisol. Along with weakness, drowsiness, fluid retention, and weight gain, Cushing's syndrome can also cause easy bruising.
• Carcinoid syndrome: Certain lung cancers can cause peptides such as serotonin to be secreted that, in addition to diarrhea, can cause facial flushing.
• Dermatomyositis: This is an inflammatory condition of the muscles. It can cause scaly red plaques on the skin of the hands, a red-purple rash around the eyelids (heliotrope rash), photosensitive skin eruptions, and dilated blood vessels in the skin.

Lung Cancer Symptoms Appearing on the Skin

With several syndromes that can result from lung cancers, a range of skin symptoms may be seen. Typical skin symptoms associated with lung cancer include the following items.

Yellow Skin

If lung cancer has spread to the pancreas or liver, it may cause jaundice. Jaundice is when your skin or the whites of your eyes turn yellow. It is caused by a buildup of bilirubin in the body.

Bilirubin is a yellow- or orange-colored substance made during the normal breakdown of red blood cells. If lung cancer has spread to the liver, pancreas, or bile ducts, it can cause higher than normal bilirubin levels.

Itchy Skin

Itchy skin can be another sign that lung cancer has spread to the liver. If the liver is affected, it can cause a buildup of bile salts that leads to itching.

Easy Bruising

Cushing's syndrome is the second most common paraneoplastic syndrome with small cell lung cancer. Certain tumors can cause the secretion of too much adrenocorticotropic hormone, which increases cortisol levels. These raised levels can lead to skin symptoms such as skin that bruises easily, significant purple stretch marks, and a red, puffy, swollen face. 

Changes to Facial Sweating

Pancoast tumors can lead to Horner syndrome. This causes flushing and a lack of sweating on one half of the face only. 

Heliotrope Rash

Heliotrope rash is a reddish-purple rash around the eyes due to dermatomyositis. Scientists suggest that dermatomyositis complicated with non-small cell lung cancer is not rare and severe lung cancer could develop rapidly.

Gottron Papules

Gottron papules are dark-red bumps or raised blotches on the knuckles, finger or toe joints, elbows, ankles, or knees. These are also caused by dermatomyositis.

Skin Symptoms During Treatment

Treatment will differ depending on the type and severity of lung cancer. Some of the treatment options for lung cancer can also cause skin symptoms. 

• Radiation therapy can cause a redness of the skin that looks and feels like sunburn. It can be quite painful.
• Chemotherapy can lead to skin bruising or bleeding easily due to low blood platelet counts.
• Immunotherapy medications such as Keytruda (pembrolizumab) and Opdivo (nivolumab) might cause changes to the skin, such as dryness or itching. Skin eruptions and itching have been reported in approximately 10% or more of patients treated with Opdivo.

Targeted therapy medication can also cause various skin problems. Examples of some of these types of drugs and the side effects they have on the skin include:

• Giotrif (afatinib): Acne-like rash to the head, chest, and back; sore and red palms of hands and soles of feet
• Iressa (gefitinib): Dry, itchy, and flaky skin
• Tarceva (erlotinib): Dry, itchy, flaky skin; acne-like rash on the face; severe reactions that may cause blistering and peeling skin
• Vargatef (nintedanib): Tiny red or purple spots on the skin that may resemble a rash
• Xalkori (crizotinib): Itchy rash
• Zykadia (ceritinib): Itchy rash, dryness

Summary

The skin can be affected by lung cancer that has spread, different syndromes associated with lung cancer, and treatments for lung cancer. Yellow skin, itchy skin, easy bruising, swelling, and changes in facial sweating may be seen.

A Word From Verywell

Lung cancer does not always cause skin symptoms, and they are not the most common symptoms to experience with this illness. Therefore, there is no need to worry if you have a little dry or itchy skin.

However, it is useful to be aware that lung cancer and some of its treatments can cause skin symptoms, especially if you already have lung cancer and are looking for signs of metastasis or treatment side effects. 

Skin symptoms can be caused by a variety of conditions ranging from eczema to cancer. If you have a new, ongoing skin concern, always make an appointment to see your doctor. A doctor will be able to diagnose the cause and put your mind at rest. 

Frequently Asked Questions

What are the early signs of lung cancer?

The most frequently recognized early signs of lung cancer include:

• A persistent cough (for at least two to three weeks)
• Recurrent chest infections
• Shortness of breath
• Coughing up blood
• Unexplained weight loss
• Arm, chest, back, or shoulder pain

How do you detect lung cancer symptoms?

Lung cancer symptoms might not always be evident at first. There is often a significant delay between the onset of symptoms and the diagnosis of lung cancer. You are more at risk for lung cancer if you smoke. It can be easy to dismiss symptoms if you have never smoked. However, lung cancer can affect anyone at any age. 

If you are experiencing symptoms or are concerned you may have lung cancer, make an appointment and get checked out even if you think it might not be anything significant. It's always better to see your doctor to rule out or confirm a diagnosis, as lung cancer can often go undetected until the later stages, when treatments are less effective. 

How is lung cancer treated?

Treatment will differ depending on the type and stage of the lung cancer. Examples of lung cancer treatment include:

• Surgery: To remove cancerous tissues
• Chemotherapy: Medication to help shrink or kill cancer
• Radiation therapy: High doses of radiation to kill cancer cells
• Targeted therapy: Medications to stop the spread and growth of cancer and reduce damage to healthy cells
• Immunotherapy: Stimulating the immune system to help fight cancer