Tripe palms is an unusual cutaneous paraneoplastic syndrome characterized by a curious rugose thickening of the palms with an accentuation of the normal dermatoglyphic ridges and sulci. Tripe palms alone or in combination with acanthosis nigricans is strongly associated with internal malignancy, especially carcinomas of the gastrointestinal tract and lung. Any patient with tripe palms must have a complete cancer workup, as in many of the cases it often precedes the malignancy by many months. We report a rare case of tripe palms with acanthosis nigricans in a 50-year-old man with advanced pancreatic adenocarcinoma. Although relatively rare, an early diagnosis is very important to find out underlying malignancy and to improve the prognosis related to the neoplasia.

We present a case of an otherwise healthy 10-year-old girl who presented with asymptomatic brown macules over the trunk and proximal extremities, of three months’ duration. The cutaneous examination revealed multiple, dark brown, discrete, round to oval macules and a few mildly elevated lesions over the trunk and proximal limbs. The individual lesion was 1-3 cm in diameter and a few showed velvety appearance over the surface. Darier's sign was negative. The histopathological study from the velvety lesion showed acanthosis, papillomatosis and increased melanin in the basal layer. The upper dermis showed sparse perivascular infiltrate of lymphocytes without any dermal melanophages. It fulfilled the criteria for idiopathic eruptive macular pigmentation with additional histological finding of papillomatosis.

Exophiala jeanselmei, a dematiaceous hyphomycete commonly found in soil, decaying vegetation, and rotting wood is one of the lesser common organisms to be associated with Chromoblastomycosis (CBM). It is more commonly associated with subcutaneous infection such as Mycetoma in patients who are engaged in agricultural activities and in phaeohyphomycosis mostly in patients who have undergone organ transplant. Here, we report a rare case of CBM caused by Exophiala jeanselmei in an elderly patient with apparently no predisposing disease condition. Exophiala spp. as an etiological agent of CBM is rare esp. in India.