Malignant Acanthosis Nigricans, Florid Cutaneous and Mucosal Papillomatosis, and Tripe Palms in a Man With Gastric Adenocarcinoma. Visits. Download . Acanthosis Nigricans associated with malignancy (or cancer) shares similar Acanthosis Nigricans Maligna (ANM); Acanthosis Nigricans. Acantosis pigmentaria: la descripción general exhaustiva comprende Los cambios en la piel son los únicos signos de la acantosis nigricans.
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Acanthosis nigricans is a skin condition characterized by symmetrical hyperpigmented, velvety, papillomatous plaques that tend to affect flexural and intertriginous areas, although it can affect any part of the body.
The diagnosis of acanthosis nigricans is based on the clinical aspect of the lesions afantosis can be classified into benign or malignant. The former is the most common and is usually associated to endocrinological disorders type 2 diabetes, acromegaly, Cushing syndrome, hypothyroidism and insulin resistanceas well as congenital abnormalities or drugs. Malignant acanthosis nigricans was first described in by Pollitzer, who noted an association with a gastrointestinal tumor.
Female year-old patient presented with the complaint of a 5-month history of progressive brown, isolated lesions on her skin located on the axillae, between her breasts, back, buttocks and internal aspect of the thighs.
The patient also complained of malaise for 1 month. Physical examination revealed hyperpigmented, hyperkeratotic verrucous plaques distributed on the axillae, intermammary region dorsum, nape of the neck, nigrucans region and buttocks, and subtler lesions on the medial aspect of the thighs, with clinical features of acanthosis nigricans Figures 1 to 3.
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We requested pathology and imaging to investigate likely paraneoplastic syndrome. On the magnetic resonance imaging, an expansive lesion in the liver was identified segment VIImeasuring 7.
The patient underwent maligma of the liver mass and after immunohistochemistry, the diagnosis of infiltrative adenocarcinoma with likely primary site in the com pancreatic and biliary tract intra or extrahepatic bile ducts or pancreas was made. The patient underwent a delicate surgical treatment due to the location right hepatectomyhowever successful, followed by chemotherapy. After surgical treatment of the malignancy, the cutaneous lesions started to resolve, with complete resolution after four months.
At the moment, the patient is clinically cured of the neoplasm and malihna no acanthosis nigricans lesions. The prognosis of patients with mlaigna and acanthosis nigricans is poor, for it is usually a high-grade neoplasm associated to metastases.
Malignant forms can be clinically indistinguishable from benign acanthosis nigricans, therefore, a good history taking is essential to investigate cases of rapid onset and a thorough physical examination is needed to evaluate the involvement of uncommon regions and extensive locations.
An approach to acanthosis nigricans
In the described case, we made an early diagnosis of an aggressive liver cancer in a dangerous location. Cure was possible due to fast therapeutic intervention. The most important signs suspicious for paraneoplastic syndrome included age, the sudden onset of the lesions, ongoing progression, involvement of extensive areas and absence of endocrinological abnormalities on screening tests.
In our case, the cancer associated to acanthosis nigricans was hepatocellular in origin, uncommon in cases of malignant acanthosis nigricans. Another important information was that the skin lesions preceded the neoplastic manifestations, what was essential for an early diagnosis and cure of the neoplasm and the skin lesions.
It is known that surgical or chemotherapeutic treatment of the tumor is associated to improvement of malignant acanthosis nigricans while dissemination of the lesions can occur when the neoplasm metastatizes.
Acanthosis nigricans – a common significant disorder usually unassociated with malignancy. Florid cutaneous papillomatosis and acanthosis nigricans maligna revealing gastric adenocarcinoma. An Bras Dermatol ; International atlas of rare skin disease. Malignant acanthosis nigricans associated with prostate cancer: J Dermatol Surg Oncol. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided the original work is properly cited.
Services acsntosis Demand Journal.
Dear editor, Acanthosis nigricans is a skin condition characterized by symmetrical hyperpigmented, velvety, papillomatous plaques that tend to affect flexural and intertriginous areas, although it can ngiricans any part of the body.
August 20, ; Accepted: Rio Branco, 39 How to cite this article.