Abstract: 45 yo man with progressive hyperkeratosis on his fingers, toes and ears.
History: This 45-year-old man consulted us for a hyperkeratosis on his fingers, toes and ears which had been progressive for 6 months.
O/E: Hyperkeratosis localized on toes, fingers, and ears (helix).
The physical exam revealed a hard left cervical lymph node.
The patient was referred to an ENT specialist whose examination revealed two carcinomas: one on the left tonsil and one on the oesophagus.
Clinical Photos:
Laboratory: N/A
Histopathology: N/A
Diagnosis: Bazex's syndrome (Acrokeratosis neoplastica)
Comments: Considering the diagnosis of Bazex's syndrome lead to the discovery of the cancers of the tonsil and oesophagus in this patient. “Bazex is a rare psoriasiform dermatosis that is consistently associated with internal malignancy, usually squamous cell carcinoma (SCC) of the upper aerodigestive tract. Skin manifestations include acute onset of onychodystrophy and violaceous scaly patches on the helices, nose, and malar and acral surfaces.” (See Reference) Usually, skin manifestations precede diagnosis of the malignancy. This is an example of a paraneoplastic syndrome.
References: Acrokeratosis Neoplastica: There is a good chapter on eMedicine
Comment: This case is presented for interest. It illustrates the importance of considering paraneoplastic disorders.
Thank you,
Eric Ehrsam
Dermatologist
Graz, Austria
No comments:
Post a Comment