Differential Diagnoses

Workup

Pulickal JK, Kaliyadan F. Acrokeratosis Paraneoplastica. StatPearls [Internet]. 2021 Jan. [QxMD MEDLINE Link]. [Full Text].
Taher M, Grewal P, Gunn B, Tonkin K, Lauzon G. Acrokeratosis paraneoplastica (Bazex syndrome) presenting in a patient with metastatic breast carcinoma: possible etiologic role of zinc. J Cutan Med Surg. 2007 Mar-Apr. 11(2):78-83. [QxMD MEDLINE Link].
Rodrigues IA Jr, Gresta LT, Cruz RC, Carvalho GG, Moreira MH. Bazex syndrome. An Bras Dermatol. 2013 Nov-Dec. 88(6 Suppl 1):209-11. [QxMD MEDLINE Link]. [Full Text].
Squires B, Daveluy SD, Joiner MC, Hurst N, Bishop M, Miller SR. Acrokeratosis Paraneoplastica Associated with Cervical Squamous Cell Carcinoma. Case Rep Dermatol Med. 2016. 2016:7137691. [QxMD MEDLINE Link].
Vatandoust S, McKay BP, McLeay W, Miliauskas J, Gordon L, Wesley JA, et al. Acrokeratosis paraneoplastica (Bazex syndrome) associated with metastatic cutaneous squamous cell carcinoma. Intern Med J. 2016 Jan. 46 (1):119-20. [QxMD MEDLINE Link].
Lau SY, Khow KS, Yong TY. Medical image. Acrokeratosis paraneoplastica with in-situ squamous cell carcinoma. N Z Med J. 2014 Feb 14. 127(1389):86-7. [QxMD MEDLINE Link].
Karabulut AA, Sahin S, Sahin M, Eksioglu M, Ustün H. Paraneoplastic acrokeratosis of Bazex (Bazex's syndrome): report of a female case associated with cholangiocarcinoma and review of the published work. J Dermatol. 2006 Dec. 33(12):850-4. [QxMD MEDLINE Link].
Sator PG, Breier F, Gschnait F. Acrokeratosis paraneoplastica (Bazex's syndrome): association with liposarcoma. J Am Acad Dermatol. 2006 Dec. 55(6):1103-5. [QxMD MEDLINE Link].
Chave TA, Bamford WM, Harman KE. Acrokeratosis paraneoplastica associated with recurrent metastatic thymic carcinoma. Clin Exp Dermatol. 2004 Jul. 29(4):430-2. [QxMD MEDLINE Link].
Ali M, Keir M, Dodd H, Cerio R. Flexural Bazex syndrome associated with tonsillar adenocarcinoma. J Drugs Dermatol. 2004 Sep-Oct. 3(5):557-9. [QxMD MEDLINE Link].
Horton L, Bedford LM, Daveluy S. Acrokeratosis paraneoplastica (Bazex syndrome) as the presenting sign of pancreatic adenocarcinoma. BMJ Case Rep. 2020 Dec 13. 13 (12):[QxMD MEDLINE Link].
Taher M, Grewal P, Gunn B, Tonkin K, Lauzon G. Acrokeratosis paraneoplastica (Bazex syndrome) presenting in a patient with metastatic breast carcinoma: possible etiologic role of zinc. J Cutan Med Surg. 2007 Mar-Apr. 11(2):78-83. [QxMD MEDLINE Link].
Valdivielso M, Longo I, Suarez R, Huerta M, Lazaro P. Acrokeratosis paraneoplastica: Bazex syndrome. J Eur Acad Dermatol Venereol. 2005 May. 19(3):340-4. [QxMD MEDLINE Link].
Crucitti A, Feliciani C, Grossi U, La Greca A, Porziella V, Giustacchini P. Paraneoplastic acrokeratosis (bazex syndrome) in lung cancer. J Clin Oncol. 2009 Dec 20. 27(36):e266-8. [QxMD MEDLINE Link].
Ljubenovic MS, Ljubenovic DB, Binic II, Jankovic AS, Jovanovic DL. Acrokeratosis paraneoplastica (Bazex syndrome). Indian J Dermatol Venereol Leprol. 2009 May-Jun. 75(3):329. [QxMD MEDLINE Link].
Lorette G, Samimi M. [Hands cutaneous exam]. Presse Med. 2013 Dec. 42(12):1582-95. [QxMD MEDLINE Link].
Roy B, Lipner SR. A Review of Nail Changes in Acrokeratosis Paraneoplastica (Bazex Syndrome). Skin Appendage Disord. 2021 Apr. 7 (3):163-172. [QxMD MEDLINE Link].
Santos-Silva AR, Correa MB, Vargas PA, Almeida OP, Lopes MA. Bazex syndrome (acrokeratosis paraneoplastica) diagnosed in a patient with oral persistent ulcerations. Head Neck Pathol. 2010 Dec. 4(4):312-7. [QxMD MEDLINE Link]. [Full Text].
Protopsaltis I, Drossou A, Katsantonis I, Roussos N, Manoludaki K, Arvanitis M, et al. Breast cancer presenting as paraneoplastic erythroderma: an extremely rare case. Case Rep Med. 2014. 2014:351065. [QxMD MEDLINE Link]. [Full Text].
Chapireau D, Adlam D, Cameron M, Thompson M. Paraneoplastic syndromes in patients with primary oral cancers: a systematic review. Br J Oral Maxillofac Surg. 2010 Jul. 48(5):338-44. [QxMD MEDLINE Link].
da Rosa AC, Pinto GM, Bortoluzzi JS, Duquia RP, de Almeida HL Jr. Three simultaneous paraneoplastic manifestations (ichthyosis acquisita, Bazex syndrome, and Leser-Trélat sign) with prostate adenocarcinoma. J Am Acad Dermatol. 2009 Sep. 61(3):538-40. [QxMD MEDLINE Link].
Humphrey SR, Hussain AS, Chandran R, Wilson B, George B. Acute Onset of Acrokeratosis Paraneoplastica (Bazex Syndrome). JAMA Dermatol. 2015 Jun. 151 (6):677-8. [QxMD MEDLINE Link].
Cabanillas M, Perez-Perez L, Sanchez-Aguilar D, Fernandez-Redondo V, Toribio J. [Acrokeratosis paraneoplastica with bullous lesions associated with esophageal squamous cell carcinoma]. Actas Dermosifiliogr. 2006 Apr. 97(3):196-9. [QxMD MEDLINE Link].
Fasanmade A, Farrell K, Perkins CS. Bazex syndrome (acrokeratosis paraneoplastica): persistence of cutaneous lesions after successful treatment of an associated oropharyngeal neoplasm. Br J Oral Maxillofac Surg. 2009 Mar. 47(2):138-9. [QxMD MEDLINE Link].
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Media Gallery

Acrokeratosis paraneoplastica. A 67-year-old woman presented with scaly plaques of the hands, feet, ears, and nose associated with esophageal squamous cell carcinoma. The eruption resolved with resection of the cancer. Image courtesy of Ronald Grimwood, MD.
Acrokeratosis paraneoplastica. A 67-year-old woman presented with scaly plaques of the hands, feet, ears, and nose associated with esophageal squamous cell carcinoma. The eruption resolved with resection of the cancer. Image courtesy of Ronald Grimwood, MD.
Bazex syndrome. Acquired palmar keratoderma in a woman with a history of breast cancer and recent primary lung cancer. Courtesy of Jeffrey J. Meffert, MD.
Bazex syndrome. Violaceous psoriasiform dermatitis on the ankles. Lung cancer appeared to be in remission; both keratoderma and psoriasiform plaques resolved quickly with clobetasol ointment. Courtesy of Jeffrey J. Meffert, MD.
At this power, a patchy lichenoid infiltrate of predominantly lymphocytes can be seen underneath an epidermis with psoriasiform hyperplasia and serum crust in the parakeratotic cornified layer (hematoxylin and eosin, 100X).
Focal vacuolar interface change is seen with associated pigment incontinence and exocytosis of lymphocytes (hematoxylin and eosin, 200X).

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Author

Katherine R Garrity, MD Resident Physician, Department of Dermatology, University of Wisconsin School of Medicine and Public Health

Katherine R Garrity, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Daniel D Bennett, MD Associate Professor and Vice Chair for Clinical Affairs, Department of Dermatology, University of Wisconsin School of Medicine and Public Health

Daniel D Bennett, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Dermatology Foundation, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Acknowledgements

Karen D Allen, MD Consulting Dermatologist, Private Practice

Karen D Allen, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Cary Chisholm, MD Dermatopathology Fellow, Department of Dermatology, University of Texas Southwestern Medical Center

Cary Chisholm, MD is a member of the following medical societies: College of American Pathologists, Texas Medical Association, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.