Bazex’s Syndrome: Dermatological Features (Acrokeratosis Paraneoplastica)

Abstract

Clinical signs and features include:

Paraneoplastic syndrome characterized by acral psoriasiform lesions: red violaceous hyperkeratotic plaques with ill-defined borders; nail changes including subungual hyperkeratosis, onycholysis, longitudinal streaks, yellow pigmentation; hyperkeratotic plaques at pressure points (knees, elbows); and hyperkeratotic plaques on the ears, nose, and cheeks

Particular findings include violet discoloration and bulbous enlargement of the distal phalanges; lesions only on the helix of the ear (not entire ear like psoriasis)

Three clinical stages: (1) poorly circumscribed skin lesions on the helices of the ears, nose, cheeks, fingers, toes, and nails associated with asymptomatic carcinomas most commonly of the upper aerodigestive tract (see Fig. 2.1b); (2) lesions which spread to the palms and soles with a locally symptomatic malignancy (see Fig. 2.1a); (3) With an untreated malignancy, erythema and scale spread to the knees, elbows, and trunk