Gaurav Vishal, Grover Chander
Department of Dermatology, University College of Medical Sciences, Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
Skin Appendage Disord. 2022 Jul;8(4):317-321. doi: 10.1159/000521269. Epub 2022 Jan 31.
Acrokeratosis paraneoplastica of Bazex (APB) is a rare paraneoplastic dermatosis having definite association with malignancy, most commonly squamous cell carcinomas (SCC) of the upper aerodigestive tract. It is characterized by psoriasiform plaques involving the ears, nose, hands, and feet. Nail changes are commonly encountered, including onychauxis, subungual hyperkeratosis, xanthonychia, onycholysis, and onychorrhexis.
We report the details of a 40-year-old male who presented with cutaneous changes involving both ears, palms, and soles and multiple nails, suggestive of APB. These typical changes were succeeded by an SCC of the lip.
DISCUSSION/CONCLUSIONS: In 70% cases of APB, nail changes precede the diagnosis of the underlying neoplasm by up to 10 months, offering a good lead-time for early suspicion of malignancy. Our case highlights the importance of recognizing these changes early. An atypical location of malignancy (lower lip) and rare presentations, including painful acrokeratosis, melanonychia striata, and chloronychia, as seen in our case, should also be kept in mind.
巴泽克斯副肿瘤性肢端角化病（APB）是一种罕见的副肿瘤性皮肤病，与恶性肿瘤有明确关联，最常见于上消化道的鳞状细胞癌（SCC）。其特征为累及耳朵、鼻子、手和脚的银屑病样斑块。常见指甲改变，包括甲肥厚、甲下过度角化、黄甲、甲剥离和甲纵裂。
我们报告一名40岁男性的详细情况，其出现累及双耳、手掌、足底和多个指甲的皮肤改变，提示为APB。这些典型改变之后出现了唇部鳞状细胞癌。
讨论/结论：在70%的APB病例中，指甲改变比潜在肿瘤的诊断提前多达10个月出现，为早期怀疑恶性肿瘤提供了良好的预警时间。我们的病例突出了早期识别这些改变的重要性。还应牢记恶性肿瘤的非典型部位（下唇）和罕见表现，如我们病例中所见的疼痛性肢端角化病、甲黑线和绿甲。
