Malignant acanthosis nigricans and tripe palms associated with pancreatic adenocarcinoma

Malignant acanthosis nigricans is a disease that has an abrupt onset and is most commonly associated with gastric adenocarcinoma. It also has occurred as a paraneoplastic phenomenon in other carcinomas. Malignant acanthosis nigricans can occur simultaneously, before, or after the onset of internal malignancy. Malignant acanthosis on the palms is referred to as tripe palms. We describe a rare association of oral malignant acanthosis nigricans and tripe palms secondary to an underlying pancreatic adenocarcinoma.