SKIN TUMORS OF THE LOWER EXTREMITIES

Tumors of the skin developing on the lower extremities are listed in Tables 1 and 2. Which of these tumors show a tendency to occur almost exclusively or regularly on the lower extremities? On the basis of our clinical experience augmented bireview of the literature, we noted at least 15 types of tumor predisposed to involve the integument and its appendages of the lower extremities (Table 3). Is there an explanation for this topographical predilection? Is there a site-specific factor involved or do these tumors develop on the lower extremities by chance? As we see it, the extent of repeated occurrence seen clinically negates chance as a factor. If disorders of the lower extremities are considered, such as erythema ab igne, “toasted skin” syndrome, tinea pedis, callosities, plantar warts,.sweaty feet, varicose ulcers, shoe dermatitis or stasis dermatitis, the circumstances accounting for their site i s readily explained. We have studied skin markers of systemic disease on the lower extremities, such as the various manifestations of ischemic and neuropathic lesions in association with diabetes, pretibial myxedema, erythema nodosum, livedo reticularis, or necrotizing vasculitis. From this study we have proposed possible hypotheses to account for this selective distribution.’ Can we speculate for tumors as we