Ann Dermatol.  2008 Dec;20(4):216-220. 10.5021/ad.2008.20.4.216.

Acrokeratosis Paraneoplastica with Adenocarcinoma of the Colon Treated with Topical Tretinoin

• Baek JO
• Lee HY
• Lee JR
• Roh JY

• KMID: 2156398
• DOI: http://doi.org/10.5021/ad.2008.20.4.216

Abstract

Acrokeratosis paraneoplastica, or Bazex syndrome, is one of the paraneoplastic syndromes. The characteristic skin lesions include palmoplantar keratoderma, psoriasiform skin lesions, hyperpigmentation, and nail dystrophy. The most common associated neoplasms are squamous cell carcinoma of the upper respiratory tract and other kinds of tumors with cervical lymph node metastasis. A 63-year-old woman presented with an 11 month history of hyperkeratotic lesions on the palms and soles. Ten months before she had been diagnosed with adenocarcinoma of the colon and undergone a left hemicolectomy. We report a case of acrokeratosis paraneoplastica associated with colon cancer which persisted after removal of the primary cancer, but resolved with topical tretinoin treatment.

Keyword

Acrokeratosis paraneoplastica; Bazex syndrome; Colon cancer; Tretinoin

MeSH Terms

Adenocarcinoma
Carcinoma, Basal Cell
Carcinoma, Squamous Cell
Colon
Colonic Neoplasms
Female
Histiocytoma, Benign Fibrous
Humans
Hyperpigmentation
Hypotrichosis
Keratoderma, Palmoplantar
Lymph Nodes
Middle Aged
Nails
Neoplasm Metastasis
Paraneoplastic Syndromes
Respiratory System
Skin
Skin Neoplasms
Tretinoin
Carcinoma, Basal Cell
Histiocytoma, Benign Fibrous
Hypotrichosis
Skin Neoplasms
Tretinoin

Figure

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  Fig. 1 Yellowish punctuate hyperkeratotic plaques on the left palm (A) and identical lesions on the right sole (B). Onycholysis on the finger nails (C) and toenails (D).

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  Fig. 2 Histologic examination demonstrates (A) hyperkeratosis, a thickened granular layer, and scattered parakeratotic columns in the stratum corneum (H&E, ×40) and (B) acanthosis, and eosinophilic and vacuolar degeneration with exocytosis in the spinous layer (H&E, ×100).

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  Fig. 3 Punctated keratoderma of the palms (A) and soles (B) was almost completely resolved, except for the nail dystrophies (C) after 2 months of treatment with topical tretinoin.

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