A diagnosis of acrokeratosis
paraneoplastica was reached after (1) a histopathologic confirmation biopsy of a well-differentiated squamous cell carcinoma of the tongue and (2) a skin biopsy consistent with a paraneoplastica syndrome.
Differential Diagnoses of Seborrheic Keratosis (1,3) Permanent or Malignant Lesions Benign Lesions * Actinic keratosis * Acrochordon (skin tags) * Bowen disease (SCC in situ) * Acrokeratosis
verruciformis * Invasive SCC / SCC in situ * Benign lichenoid keratosis * Lentigo maligna * Condyloma acuminatum * Malignant melanoma * Eocrine poroma/hidroacanthoma simplex * Pigmented basal cells * Melanooytic nevus * Verruca vulgaris (warts) * Solar lentigo (liver spots) * Tumor of the infundibulum SCC=squamous cell carcinoma.
paraneoplastica, otherwise known as Bazex syndrome, is a paraneoplastic syndrome in which cutaneous lesions appear in association with an underlying malignancy.
The differential es acrokeratosis
verruciformis of Hopf, Gro ver's disease, Hailey-Hailey disease, and pemphigus vegetans.1
Acantholytic disorders of the skin: Darier-White disease, acrokeratosis
verruciformis, grover disease, and Hailey-Hailey disease," in Fitzpatrick's Dermatology in General Medicine, 7e, K.
(240) Mucocutaneous manifestations are multiple facial trichilemmomas, especially surrounding the nose, mouth, and ears, as well as sclerotic fibromas, acrochordons, punctate keratoses of the palms and soles, acrokeratosis
verruciformis, and oral papillomas ("scrotal tongue").
The most common skin paraneoplastic manifestations are acanthosis nigricans, erythromelalgia, thrombotic thrombocytopenic purpura, acrokeratosis
paraneoplastica, paraneoplastic hypertrichosis lanuginosa acquisita, dermatomyositis, systemic sclerosis, and scleroderma [11-13].
The following disorders should be considered in the differ-ential diagnosis of porokeratosis: elastosis perforans for PM, actinic keratosis and stucco keratosis for DSAP, lichen sclero-sus et atrophicus, lichen planus, acrokeratosis
verruciformis, Bowen's disease, and squamous cell carcinoma for single le-sions (13).
Darier-White disease (keratosis follicularis) and acrokeratosis
Involvement of hands include punctate keratosis, palmar pits and haemorrhagic macules, acrokeratosis
verruciformis like lesions are present in half the patients.
Many psoriasiform dermatoses, such as erythroderma, pityriasis rubra pilaris, acrokeratosis
paraneoplastica, and the nutritional deficiency dermatitides, always affect other body sites when they affect the face, and thus, they do not appear in facial biopsies.