Acrokeratosis paraneoplastica (Bazex syndrome) is a paraneoplastic skin condition that may appear before the tumor is clinically evident. Early recognition may allow for early cancer detection and therapy with improved survival.


Key clinical features:

(1) violaceous erythema and scaling (psorasiform eruption) affecting the nose, fingers, toes and aural helices

(2) nail dystrophy


Variable findings:

(1) keratoderma

(2) pruritus

(3) vesicles and/or bullae

(4) spread of the psorasiform dermatitis over limbs and trunk

(5) sterile paronychia

(6) hyperpigmentation of the psorasiform eruption


The condition may remit with successful cancer therapy only to relapse with tumor recurrence.


Associated tumors:

(1) respiratory tract (common)

(2) orophyarnx, esophagus or stomach, often a squamous cell carcinoma (common)

(3) colon

(4) bladder

(5) prostate

(6) endometrium

(7) vulva

(8) neuroendocrine

(9) malignant lymphoma

(10) nodal metastases from unknown primary


Histologic features may include:

(1) acanthosis

(2) hyperkeratosis with parakeratosis

(3) spongiosis

(4) degenerating or necrotic basal cells at the dermoepidermal junction

(5) perivascular lymphocytic infiltrate in the upper dermis


To read more or access our algorithms and calculators, please log in or register.