Acrokeratosis paraneoplastica in serous ovarian carcinoma: case report

Abstract

BackgroundAcrokeratosis paraneoplastica is a rare paraneoplastic phenomenon associated with upper aerodigestive tract carcinomas, usually manifesting as psoriasiform keratosis over the acral sites. It is primarily seen in white males above the age of 40 years. Here we report a case of paraneoplastic acrokeratosis in a woman with serous ovarian cancer. To the best of our knowledge, no similar case has been reported previously.Case presentationWe report the case of a 60-year-old woman diagnosed with a serous ovarian cancer and complaining of a thickening and peeling of the skin on her feet. Clinical and histological examination, as well as the course of disease, confirmed the diagnosis of a paraneoplastic plantar keratosis. Under systemic chemotherapy with carboplatin and paclitaxel the lesion resolved gradually in concordance with tumour marker CA 125.ConclusionsWe present the reported case of paraneoplastic acrokeratosis associated with advanced high-grade ovarian cancer.

Síndrome de Bazex asociado a carcinoma de orofaringe. Descripción de un caso

“…Una teoría es la existencia de mimetismo molecular, una reacción cruzada entre antígenos tumorales y receptores del factor de crecimiento en las células epidérmicas. Otra explicación posible implica la interacción directa entre la piel y las citocinas secretadas por las células tumorales, como el factor de crecimiento transformante y el factor de crecimiento similar a la insulina [2,6]. Niveles bajos de vitamina A sérica también podrían influir en el desarrollo de las lesiones cutáneas características [3,4].…”

Acrokeratosis Paraneoplastica Associated with Cervical Squamous Cell Carcinoma

“…Acrokeratosis paraneoplastica involves bilateral psoriasiform cutaneous lesions that initially present on acral surfaces, especially the ears, nose, hands, and feet, spreading centripetally [2, 4, 5]. Three clinical stages exist to describe the sequence of cutaneous lesions in relation to the underlying neoplasia: (1) in a locally asymptomatic malignancy, cutaneous lesions present on the nose, ear helices, fingers, toes, and nails; (2) in a locally symptomatic malignancy, palmoplantar surfaces are affected; (3) in a symptomatic malignancy left untreated, lesions advance to the patient's knees, elbows, and trunk [4, 6].…”

“…Hyperkeratotic plaques with associated erythema and scale present in a symmetric acral distribution and spread centripetally, accompanied by nail changes, including onycholysis and ungual dystrophy [3–5]. Ears and nails are most commonly affected, followed by the nose, hands, and feet [2]. Skin changes typically improve with treatment of the underlying malignancy.…”

Bazex syndrome

“…1,2 This paraneoplastic skin condition usually precedes a cancer diagnosis by two to six months. It is characterized by symmetric desquamative erythema with bluish or violet discoloration, onychodystrophy or keratoderma.…”

“…1 Lesions are typically located on the fingers, toes, ears and nose. 1,2 Resistance to conventional treatments, including steroids, may alert physicians to an underlying malignant tumour. 1 In most cases, improvement occurs after treatment of the primary tumour.…”