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