Tripe palms and Malignant Acanthosis Nigricans: More than a diagnostic pointer

Area of Science:

• Dermatology
• Oncology
• Gastroenterology

Background:

• Tripe palms (TP) is a rare cutaneous paraneoplastic manifestation associated with intra-abdominal malignancies.
• TP often co-occurs with malignant acanthosis nigricans (MAN), potentially preceding the primary cancer diagnosis by years.
• The presence of TP and MAN is clinically significant as an early indicator of internal malignancy.

Observation:

• A case of a 71-year-old postmenopausal female with ovarian cancer is presented.
• The patient reported symptoms of dyspepsia, abdominal distension, and weight loss.
• TP and MAN were diagnosed 4 years prior to the ovarian cancer diagnosis.

Findings:

• The co-occurrence of TP and MAN can serve as a crucial early warning sign for occult intra-abdominal malignancies.
• This case highlights the significant time lag between the appearance of these dermatological markers and the definitive cancer diagnosis.
• The patient's presentation underscores the importance of investigating these skin conditions thoroughly.

Implications:

• The unique presentation of TP and MAN preceding the primary illness necessitates extensive early diagnostic work-up for malignancy.
• Consideration for surgical intervention should be evaluated early in patients presenting with TP and MAN due to tumor biology.
• Increased awareness and prompt evaluation of TP and MAN can lead to earlier cancer detection and potentially improved patient outcomes.