The
n e w e ng l a n d j o u r na l
of
m e dic i n e
Images in Clinical Medicine Lindsey R. Baden, M.D., Editor
Acrokeratosis Paraneoplastica A
B
C
D
E
F
A
66-year-old man presented to the clinic with a 4-week history Frank S. van Leersum, M.D. of painful, edematous, and scaly ears, a condition that was later accompa- Xiaomeng Liu, M.D. nied by itchy, hyperkeratotic plaques on the palms and soles with surround- Maastricht University Medical Center ing erythema (Panels A, B, and C). The skin lesions were noted to be symmetric. Maastricht, the Netherlands Previous treatment with a 0.05% formulation of clobetasol cream was unsuccessful. [email protected] He was also discovered to have an enlarged mass on the left side of his neck and weight loss of 4 kg without other B symptoms (i.e., fever, night sweats, and weight loss). Bazex’s syndrome (acrokeratosis paraneoplastica) was suspected, and cytologic analysis of the enlarged lymph node showed metastasis of a poorly differentiated squamous-cell carcinoma. The presence of a squamous-cell carcinoma of the oropharynx (tumor stage 4a, lymph-node stage 2c, and no distant metastasis) was confirmed on computed tomography and positron-emission tomography–computed tomography. The patient underwent chemoradiotherapy for 6 weeks, after which the skin condition cleared (Panels D, E, and F). Nine months after the initial diagnosis, the patient died from complications of metastatic disease.
DOI: 10.1056/NEJMicm1502488 Copyright © 2015 Massachusetts Medical Society.
n engl j med 373;22
nejm.org
November 26, 2015
The New England Journal of Medicine Downloaded from nejm.org on November 26, 2015. For personal use only. No other uses without permission. Copyright © 2015 Massachusetts Medical Society. All rights reserved.
2161
n e w e ng l a n d j o u r na l
of
m e dic i n e
Images in Clinical Medicine Lindsey R. Baden, M.D., Editor
Acrokeratosis Paraneoplastica A
B
C
D
E
F
A
66-year-old man presented to the clinic with a 4-week history Frank S. van Leersum, M.D. of painful, edematous, and scaly ears, a condition that was later accompa- Xiaomeng Liu, M.D. nied by itchy, hyperkeratotic plaques on the palms and soles with surround- Maastricht University Medical Center ing erythema (Panels A, B, and C). The skin lesions were noted to be symmetric. Maastricht, the Netherlands Previous treatment with a 0.05% formulation of clobetasol cream was unsuccessful. [email protected] He was also discovered to have an enlarged mass on the left side of his neck and weight loss of 4 kg without other B symptoms (i.e., fever, night sweats, and weight loss). Bazex’s syndrome (acrokeratosis paraneoplastica) was suspected, and cytologic analysis of the enlarged lymph node showed metastasis of a poorly differentiated squamous-cell carcinoma. The presence of a squamous-cell carcinoma of the oropharynx (tumor stage 4a, lymph-node stage 2c, and no distant metastasis) was confirmed on computed tomography and positron-emission tomography–computed tomography. The patient underwent chemoradiotherapy for 6 weeks, after which the skin condition cleared (Panels D, E, and F). Nine months after the initial diagnosis, the patient died from complications of metastatic disease.
DOI: 10.1056/NEJMicm1502488 Copyright © 2015 Massachusetts Medical Society.
n engl j med 373;22
nejm.org
November 26, 2015
The New England Journal of Medicine Downloaded from nejm.org on November 26, 2015. For personal use only. No other uses without permission. Copyright © 2015 Massachusetts Medical Society. All rights reserved.
2161
![[Acrokeratosis paraneoplastica of Bazex].](/assets/img/hold.png)
