Ann Dermatol Vener
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Case Reports
[Tripe palms and a hypertrophic osteoarthropathy syndrome revealing a neuroendocrine carcinoma of the lung].
Tripe palms is a rare cutaneous paraneoplastic syndrome, primarily evocative of lung and gastric neoplasia. Association of many paraneoplastic diseases has also been reported. ⋯ "Tripe palms" or "osteoarthritic acanthosis" is a paraneoplastic syndrome. It involves an acquired keratoderma taking on a yellow velvety appearance with accentuation of dermatoglyphic lines. Malignancy is discovered in over 90% of individuals with tripe palms. If malignancy is isolated, it mostly involves the lung (53%). Gastric cancer is associated in 77% of cases if the condition is associated with acanthosis nigricans. In approximately one third of cases, the keratoderma may resolve, generally after treatment of the tumour. The association of many paraneoplastic syndromes has also been reported, in particular digital clubbing and hypertrophic osteoarthropathy. At least 90% of cases of hypertrophic osteoarthropathy in adults occur in patients who have or will eventually develop a malignancy. It is characterized by periostosis of long bones, joint pain, and clubbing, and it is often seen on bone scintigraphy during staging of lung carcinoma.
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In 1964, based on eight cases, R. Sweet described a form of "acute febrile neutrophilic dermatosis" that was quickly renamed Sweet's syndrome. Over time, other entities (pyoderma gangrenosum, erythema elevatum diutinum, etc.) came to be included in the same nosological group, giving rise to the concept of neutrophilic dermatosis. In addition to types of passage between these different diseases, neutrophilic dermatoses may have a variety of atypical presentations such as that described as "neutrophilic dermatosis of the hands", of which we present a case herein. ⋯ This case highlights the difficulties in clearly distinguishing forms of neutrophilic dermatosis, adding to the notion of a continuum in neutrophilic disease.