title: [Tripe palms and a hypertrophic osteoarthropathy syndrome revealing a neuroendocrine carcinoma of the lung].
abstract: BACKGROUND
  Tripe palms is a rare cutaneous paraneoplastic syndrome, primarily evocative of lung and gastric neoplasia. Association of many paraneoplastic diseases has also been reported.
  
  
  METHODS
  A 49-year-old man with a history of alcoholism and smoking addiction reported haemoptysis and thoracic pains present for one year. The physical examination showed left lung condensation. The skin examination revealed a thickened yellowish keratoderma with exaggerated skin ridges and digital clubbing. A diagnosis of paraneoplastic tripe palms was made, prompting repetition of the biopsy which ultimately revealed a neuroendocrine carcinoma. Skeletal scintigraphy showed periosteal proliferation with hypertrophic osteoarthropathy.
  
  
  CONCLUSIONS
  "Tripe palms" or "osteoarthritic acanthosis" is a paraneoplastic syndrome. It involves an acquired keratoderma taking on a yellow velvety appearance with accentuation of dermatoglyphic lines. Malignancy is discovered in over 90% of individuals with tripe palms. If malignancy is isolated, it mostly involves the lung (53%). Gastric cancer is associated in 77% of cases if the condition is associated with acanthosis nigricans. In approximately one third of cases, the keratoderma may resolve, generally after treatment of the tumour. The association of many paraneoplastic syndromes has also been reported, in particular digital clubbing and hypertrophic osteoarthropathy. At least 90% of cases of hypertrophic osteoarthropathy in adults occur in patients who have or will eventually develop a malignancy. It is characterized by periostosis of long bones, joint pain, and clubbing, and it is often seen on bone scintigraphy during staging of lung carcinoma.
authors: Service de dermatologie et vénéréologie, CHU Hassan II, Atlas-Fès, Maroc. amalbg@gmail.com
authors: A
authors: A
authors: El Bakkal
authors: R
authors: R
authors: Idrissi
authors: M
authors: M
authors: Meziane
authors: O
authors: O
authors: Mikou
authors: M
authors: M
authors: Sekal
authors: H
authors: H
authors: Belghiti
authors: A
authors: A
authors: Bennani
authors: K
authors: K
authors: Znati
authors: A
authors: A
authors: Amarti
authors: F
authors: F
authors: Karkos
authors: B
authors: B
authors: Amara
authors: M
authors: M
authors: El Biaze
authors: M C
authors: MC
authors: Benjelloun
authors: S
authors: S
authors: Brahmi
authors: O
authors: O
authors: Elmesbahi
authors: F Z
authors: FZ
authors: Mernissi
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D018287:Carcinoma, Large Cell / Q000150:complications / Q000175:diagnosis*; D018278:Carcinoma, Neuroendocrine / Q000150:complications / Q000175:diagnosis*; D053379:Chromogranin A / Q000032:analysis; D003878:Dermatoglyphics; D006801:Humans; D007642:Keratosis / Q000209:etiology* / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D008207:Lymphatic Metastasis; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis / Q000378:metabolism; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000209:etiology*; D010166:Palliative Care; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000473:pathology; D011877:Radionuclide Imaging; D012907:Smoking / Q000009:adverse effects; D016708:Synaptophysin; D013977:Tibia / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D033921:Vesicular Transport Proteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D009363:Neoplasm Proteins; C569014:SYP protein, human; D016708:Synaptophysin; D033921:Vesicular Transport Proteins