Diagnosis: Acrokeratosis paraneoplastica (AP) (Bazex syndrome).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Routine hematoxylin-eosin staining of the biopsy specimen revealed hyperkeratosis, focal parakeratosis, and psoriasiform hyperplasia with spongiosis and focal microvesiculation as well as a superficial to middermal perivascular lymphocytic infiltrate.
Based on the clinical and microscopic findings, a diagnosis of AP was made. Chemotherapy and radiation therapy resulted in only partial improvement, although at the time of the patient’s referral, his disease was thought to be in remission. Further evaluation was suggested. Approximately 2 months after diagnosis, he developed hip pain and was found to have advanced disease, with lytic metastatic involvement of the left ischium. He died within 6 weeks after the metastases were detected.
DISCUSSION
Acrokeratosis paraneoplastica was originally described in 1965 in a French man with typical skin lesions and a carcinoma of the pyriform sinus.1 The skin findings cleared on treatment of the tumor. Since then, AP has been recognized as a rare paraneoplastic condition that is mostcommonly . . . [Full Text of this Article]
