ArticleAnnals of medicine and surgery (2012)2025
Malignant acanthosis nigricans and tripe palms: cutaneous indicators of gastric carcinoma resolution - a case report.
Article in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and importance: Malignant acanthosis nigricans (MAN) and tripe palms (TP) are rare dermatological conditions that serve as paraneoplastic indicators of internal malignancies, most notably gastric carcinoma. Importance of this reported case is that recognizing these cutaneous signs is crucial for early cancer detection. Presentation: We report a 47-year-old male with a six-month history of progressive hyperpigmentation and thickening of the skin in the neck, axillae, foot, palm, and groin, along with rugose, hyperkeratotic changes in both palms. Initial treatments with topical agents were ineffective. Physical examination revealed velvety, hyperpigmented plaques characteristic of MAN and thickened, rugose skin on the palms indicative of TP. Elevated CA19.9 levels (>1200.00 U/ml) and video esophagogastroduodenoscopy revealed ulcerative growth in the fundus and body of the stomach. CT scans showed circumferential asymmetric wall thickening and perigastric lymphadenopathy. The patient was diagnosed with gastric adenocarcinoma and underwent neoadjuvant chemotherapy followed by a D2 total gastrectomy with lymphadenectomy. Discussion: The combination of MAN and TP is strongly associated with underlying malignancies, particularly gastric carcinoma. The pathogenesis involves growth factor receptor pathways leading to skin proliferation. This case highlights the importance of dermatological signs as early indicators of internal malignancies. The resolution of MAN and TP post-surgery confirmed their paraneoplastic nature, underscoring the significance of early recognition and intervention. Conclusion: This case underscores the importance of identifying MAN and TP as critical dermatological clues for underlying malignancies. Early detection and multidisciplinary management can lead to timely surgical intervention, improving both dermatological symptoms and overall prognosis. Increased awareness of these paraneoplastic conditions can significantly aid in the early diagnosis of life-threatening cancers such as gastric carcinoma.
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