Tripe Palms Research Articles

Annular and Acral/facial Dyskeratotic Paraneoplastic Disorders.

Annular and acral/facial dyskeratotic paraneoplastic disorders are inflammatory dermatoses that occur in association with distant cancers but are not precursors, extensions, or metastases of them. There are four classical entities under this rubric: two gyrate entities: erythema annulare centrifugum and erythema gyratum repens, and two acral/facial dyskeratotic entities: acrokeratosis paraneoplastic (Bazex syndrome) and tripe palms. Each of these entities may also occur in association with another etiopathogenesis and may present either as a classical entity or as a barely recognizable disease. We shall discuss these entities, their associated causes, and their differential diagnoses in turn.

An Unusual Paraneoplastic Manifestation of Adenocarcinoma Lung

Tripe palms (TP) are the rare paraneoplastic manifestation with the thickened palms and pronounced dermatoglyphics. In cancer patients with mere TP, the most occurring malignancy is pulmonary carcinoma. Although it precedes a malignancy, it may arise at any point in the course of the disease. Here, we present a patient who came with complaints of thickened blackish discoloration of palms and soles for 3 weeks and a clinical diagnosis of TP was made. He had concomitant adenocarcinoma lung TNM stage IB diagnosed 5 months back. Thus, he was diagnosed with TP secondary to adenocarcinoma lung. Although TP precede internal malignancy we report this case as TP occurred after the diagnosis of adenocarcinoma of the lung was made.

Rak żołądka we wczesnym stadium z występowaniem flaków palmowych i rogowacenia czarnego

Tripe palm is a rare cutaneous paraneoplastic syndrome that can be overlooked and frequently appears with acanthosis nigricans. If tripe palm and acanthosis nigricans occur in a patient together, gastric cancer should come to mind. A 50-year-old female patient had signs of abdominal pain and velvety thickening in the palms and soles. Tripe palm and acanthosis nigricans were considered as paraneoplastic syndrome after other benign causes were excluded. It was determined that the underlying malignancy was gastric cancer. After neoadjuvant FLOT chemotherapy regimen, gastrectomy was performed, and the patient received adjuvant chemotherapy. With the recognition of tripe palm, a rare cutaneous paraneoplastic syndrome, patients can be diagnosed and treated early.

Hyperplasia-associated cutaneous paraneoplasia

Hyperplasia-associated cutaneous paraneoplasia is an important differential diagnosis in everyday clinical practice. An early diagnosis of the underlying tumor disease can significantly improve the patient's prognosis. Hyperplasia is probably mainly cytokine-mediated. The primary tumor and/or the metastases release growth factors and transcription factors which, via epidermal growth factors, lead to hyperproliferation of keratinocytes. Symmetrical mainly intertriginous hyperpigmentation with partially verrucous hyperplasia and lichenification mostly in association with gastric adenocarcinoma. Special forms are florid cutaneous papillomatosis and tripe palms. Pseudoacanthosis nigricans is to be distinguished (metabolic and hormonal disorders). LESER-TRéLAT SYNDROME: Eruptive occurrence of seborrheic keratosis associated with visceral tumors. Erythema and scaling initially at the bridge of the nose, ear helix and acra with later spread, associated with tumors of the upper aerodigestive system. It should be clinically differentiated from psoriasis. The treatment of the primary tumor is decisive, which also leads to adecrease of cutaneous symptoms. Reappreance suggests tumor recurrence.

Tripe palms with acanthosis nigricans: Unusual cutaneous markers of poorly differentiated hepatocellular carcinoma

Tripe palms with acanthosis nigricans: Unusual cutaneous markers of poorly differentiated hepatocellular carcinoma

Acanthosis nigricans malin révélant un cholangiocarcinome

IntroductionAcanthosis nigricans is a dermatosis characterized by the presence of a hyperpigmented, velvety cutaneous thickening in the flexural areas, especially axillary and inguinal fossas, and lateral faces of the neck. AN is usually a benign condition but can sometimes reveal an internal malignancy corresponds to a cutaneous paraneoplasic syndrome. Literature shows a predominant association with gastric adenocarcinoma. Here, we report a rare association between AN and cholangiocarcinoma. Case reportWe report a 43-year-old woman who presented an extensive AN associated to a tripe palms syndrome and florid cutaneous papillomatosis. She consulted in dermatology because of the itchiness of the lesions as well as for esthetics reasons. Complementary investigations enabled to diagnose a cholangiocarcinoma without visceral metastasis and she was treated by tumor resection and chemotherapy. Consequently, a slight improvement of the skin condition and the disappearance of pruritus were observed. ConclusionAN should be considered as cutaneous sign either of malignancy or endocrinopathy and therefore requires further investigations. The existence of extensive lesions, pruritus, tripe palms syndrome, florid cutaneous papillomatosis or mucous lesions, associated to an AN is a sign of malignancy should be investigated urgently the early diagnosis of which can lead to a better prognosis.

Association pachydermatoglyphie et gammapathie monoclonale de signification indeterminée

Association pachydermatoglyphie et gammapathie monoclonale de signification indeterminée

Cutaneous paraneoplastic syndromes

A variety of cutaneous abnormalities can be seen in patients with malignant diseases, some of which are infectious, with others representing direct involvement of the skin by the underlying disorder. Yet another group of lesions can be regarded as associated markers of the malignant process, and, as such, are termed "paraneoplastic." This review considers the latter collection of conditions, grouping them by the generic type of malignancy that is usually linked to the paraneoplasia. Some of the processes show a predominant association with alimentary tract malignancies (acanthosis nigricans, acrodermatitis paraneoplastica, florid cutaneous papillomatosis, necrolytic migratory erythema, palmoplantar keratoderma, pancreatic fat necrosis, and pityriasis rotunda). Others are usually linked to a hematolymphoid malignancy (acquired ichthyosis, exfoliative erythroderma, necrobiotic xanthogranuloma, pemphigus paraneoplastica, plane xanthoma, pyoderma gangrenosum, scleromyxedema, Sweet syndrome, and leukocytoclastic vasculitis). Finally, yet another collection of paraneoplastic skin disorders can associate themselves with anatomically-diverse malignancies (Leser-Trelat syndrome, Trousseau syndrome, dermatomyositis, erythema gyratum repens, hypertrichosis lanuginosa acquisita, papuloerythroderma of Ofuji, tripe palms, and multicentric reticulohistiocytosis). Recognition of these processes by the pathologist can be a valuable step in the characterization of underlying malignant diseases.

Oral Malignant Acanthosis Nigricans and Tripe Palms Associated With Renal Urothelial Carcinoma.

Oral Malignant Acanthosis Nigricans and Tripe Palms Associated With Renal Urothelial Carcinoma.

Cutaneous Infection Caused by Plant PathogenColletotrichum gloeosporioides

oped persistent lip plaques despite successful oncological treatment.5 Others report the use of retinoids for its keratolytic effects, but with varying outcomes due to the underlying cancer.3 Only 1 other case has described improvement in oral lesions with systemic retinoids.6 This patient had metastatic gastric carcinoma but was eventually lost to follow-up. To our knowledge, this is the first report of oral malignant AN and tripe palms occurring in association with invasive renal urothelial carcinoma. Despite palliative chemotherapy, the patient’s oral symptoms persisted and only improved after 8weeks of acitretin treatment. Apalliative approachwas adoptedwith the aimof improvingher eating ability and nutritional status. In malignant AN, successful treatment of the underlying cancer results in improvement of cutaneous or oral signs.We wish tohighlight that systemic retinoids canbe considered for symptomatic relief inpatientswithmetastaticor late-stagecarcinomas, thereby improving nutritional status and quality of life.

Distant skin metastases as primary presentation of gastric cancer.

Distant gastric metastasis to the skin is uncommonly a presenting symptom, although nonspecific paraneoplastic syndromes with dermatologic manifestation including diffuse seborrheic keratoses (Leser-Trelat sign), tripe palms, and acanthosis nigricans have been described in the literature. We report here the case of a 49-year-old woman with gastric adenocarcinoma who presented with cutaneous metastasis as an initial symptom. In our case, metastatic skin lesions responded significantly to EOX chemotherapy (epirubicin+oxaliplatin+capecitabine) despite progression of systemic disease. In similar presentations, a high index of clinical suspicion and skin biopsy are important.

Malignant Acanthosis Nigricans, Florid Cutaneous Papillomatosis and Tripe Palms Syndrome Associated with Gastric Adenocarcinoma - a Case Report

Abstract Malignant acanthosis nigricans is a rare obligate paraneoplastic dermatosis which accounts for 20% of all acanthosis nigricans cases. The clinical features of the disease are the same as in the benign forms: symmetrical, hyperpigmented, velvety papillomatous lesions mostly involving the axillae, neck, groins, periumbilical cubital and popliteal areas, mammary areolae and less often mucous membranes. However, unlike other forms, it is characterized by sudden onset and rapid spread, commonly (80%) after the age of 40, which may be a marker of malignancy and a key to early diagnosis, indicating the need for a detailed examination. It is a disorder that has no gender differences. Most cases are detected at the moment of cancer diagnosis (61.3%), in fewer cases (about 20%) prior to cancer diagnosis, and in 21% at a later stage of malignant disease. Acanthosis nigricans is usually associated with one of the three or all three forms of paraneoplastic lesions: florid cutaneous papillomatosis, acanthosis palmaris (tripe palms, pachydermatoglyphia) involving the palms and soles, as well as multiple seborrheic keratosis (sign of Leser-Trélat). We report on a female patient with clinically established three paraneoplastic syndromes: malignant acanthosis nigricans, florid cutaneous papillomatosis, and acanthosis palmaris, which appeared before the diagnosis of advanced gastric adenocarcinoma, leading to fatal outcome.

Malignant acanthosis nigricans, florid cutaneous papillo matosis and tripe palms syndrome associated with gastric adenocarcinoma

Malignant acanthosis nigricans is a rare paraneoplastic skin syndrome mostly associated with gastric adenocarcinoma. Florid cutaneous papillomatosis and tripe palms syndrome are considered to be abortive clinical variants of acanthosis nigricans. Clinical manifestations include pruritic, hyperkeratotic and hyperpigmented plaques with a subsequent formation of velvety papillomas in the involved areas. This case report describes an unusual case of the patient diagnosed with a combination of malignant acanthosis nigricans, florid cutaneous papillomatosis and tripe palms syndrome associated with gastric adenocarcinoma.

Acanthosis nigricans, tripe palms, and sign of Leser‐Trélat in a patient with gastric adenocarcinoma: case report and literature review in China

Acanthosis nigricans, tripe palms, and sign of Leser‐Trélat in a patient with gastric adenocarcinoma: case report and literature review in China

Paraneoplastic cutaneous manifestations: concepts and updates*

The skin often signals systemic changes. Some neoplastic diseases that affect internal organs may trigger several cutaneous manifestations. Although these dermatoses are relatively unusual, the recognition of some typical paraneoplastic dermatoses may lead to the early diagnosis of a neoplasm and determine a better prognosis. In this review article, we discuss the paraneoplastic cutaneous manifestations strongly associated with neoplasms, which include acanthosis nigricans maligna, tripe palms, erythema gyratum repens, Bazex syndrome, acquired hypertrichosis lanuginosa, necrolytic migratory erythema, Leser-Trélat sign and paraneoplastic pemphigus. We also review the clinical manifestations of each condition and include updated knowledge on disease pathogenesis.

A rare case of malignant acanthosis nigricans in a lady with ovarian cancer

“Tripe palms” or pachydermatoglyphy is a descriptive term of acanthosis nigricans of the palms and is associated with internal malignancy. It often precedes the diagnosis of a new or recurrent tumor. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. In patients with both tripe palms and acanthosis nigricans, gastric carcinoma is the most common followed by lung carcinoma. There are very few reports in the literature of malignant acanthosis nigricans associated with gynecological malignancies. We report this case because of its rarity. A 47-year-old lady presented with lower abdominal swelling and progressive hyperpigmentation which preceded the abdominal swelling by 6 months. On investigations, she was found to have ovarian cancer. The presence of acanthosis nigricans in conjunction with tripe palms in a female patient is highly suggestive of an internal malignancy including an ovarian cancer and demands an extensive search for the hidden ovarian cancer.

Three paraneoplastic signs in the same patient with gastric adenocarcinoma

This is the report of a 76-year-old male with typical lesions of acanthosis nigricans maligna (ANM), florid cutaneous papillomatosis (FCP), and tripe palms (TP) for 2 years. He did not have any gastrointestinal complaints. Pathologic findings of skin supported the diagnosis of ANM. Because gastric adenocarcinoma is the most common neoplasm associated with these paraneoplastic dermatoses, further tests were carried out. Endoscopic examination was performed and an adenocarcinoma of the esophagogastric junction was confirmed. Meanwhile, multiple small polyps in the middle and the lower thirds of the esophagus were observed. The patient was referred for further evaluation and subsequent surgical resection of the tumor.Acanthosis nigricans (AN) is a hyperkeratotic mucocutaneous eruption of heterogenous etiology, which is characterized by hyperpigmentation, velvety cutaneous thickening, intensified skin markings, and development of verrucous excrescences typically involving the intertriginous areas. AN is classified into benign and malignant forms on the basis of clinical associations. Malignant acanthosis nigricans (MAN) tends to be extensive and involves mucosal surfaces, mostly in elderly people. Florid cutaneous papillomatosis (FCP), also known as the Schwartz-Burgess syndrome, is characterized by the rapid appearance of multiple verrucous lesions that are clinically indistinguishable from common warts [1]. Tripe palms (TP) is characterized by diffuse, yellowish palmar hyperkeratosis, with enhancement of the epidermal ridges on the hands (dermatoglyphics), resembling intestinal villosities [1]. The association of these three paraneoplastic dermatoses (FCP, ANM and TP) in the same patient has been reported. Herein, we report an elderly male with three paraneoplastic dermatoses for two years. On the initial presentation, he did not report any systemic complaints; diagnostic tests confirmed the presence of a gastric adenocarcinoma.

Tripe palms associated with malignant acanthosis nigricans in a patient with gastric adenocarcinoma: A case report and review of the literature

Tripe palms (TP) is a rare dermatologic condition. TP alone, or associated with malignant acanthosis nigricans (MAN), in most cases is a cutaneous paraneoplastic disorder and its recognition should prompt a full diagnostic work-up for an underlying malignancy. We report a case of a patient in whom the correct identification of TP and MAN has allowed early diagnosis of gastric cancer. Paraneoplasias are frequently the first sign of an underlying malignant tumor. Although relatively rare, they need to be recognized by dermatologists to make an early diagnosis and improve the prognosis related to the neoplasia.

Acanthosis nigricans and "tripe palm" as paraneoplastic manifestations of metastatic tumor

Acanthosis nigricans is a common dermatosis and is most often associated with benign conditions, such as insulin resistance. It is rare as a paraneoplastic marker. As such, it is characterized by sudden onset and rapid dissemination of velvety and hyperchromic skin lesions. The term "tripe palm" refers to exaggeration of the palmar ridge pattern, which resembles the internal surface of the bovine intestinal tract. This is a paraneoplastic marker of high specificity, with 90% of the cases being associated with malignancy. We report the case of a patient with stage IV ovarian adenocarcinoma presenting acanthosis nigricans and tripe palm. Both findings are closely correlated to the neoplasm course.

A Primary Pulmonary Carcinoma With Combined Neuroendocrine and Squamous Cell Features in a Patient With Long-standing Tripe Palms and Digital Clubbing

INTRODUCTION: Cutaneous paraneoplastic syndromes are rare, but frequently herald the presence of an occult internal malignancy. Often documented after a diagnosis of cancer is made, skin manifestations are postulated to be of concurrent onset with the neoplastic process (1). We report a case of a primary pulmonary carcinoma in a patient with cutaneous abnormalities noted on physical examination for several years prior to diagnosis.