Tripe palms is most often encountered as a paraneoplastic disorder but it can occur with nonneoplastic conditions. It appears to be related to elevated serum levels of epidermal growth factor.


Synonyms: velvet palms, acanthosis palmaris, pachydermatoglyphy, palmar keratoderma



(1) keratoderma of the skin over the palms and flexor surface of the fingers, which may have a velvety texture

(2) variable involvement of the plantar surfaces of the feet

(3) prominent dermatoglyphics


The keratoderma tends to be more prominent over pressure sites.


Paraneoplastic associations:

(1) lung carcinoma

(2) gastrointestinal cancer (gastric, colon, other)

(3) renal or bladder cancer

(4) ovarian, endometrial or cervical cancer

(5) breast cancer

(6) pancreatic cancer

(7) malignant melanoma

(8) prostate cancer


Non-cancer associations:

(1) diabetes mellitus

(2) autoimmune thyroid disease

(3) bullous pemphigoid


Additional paraneoplastic findings that may accompany tripe palm:

(1) digital clubbing

(2) acanthosis nigricans

(3) arthropathy


Treatment of the underlying malignancy may result in resolution of the skin changes.


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