[Pathogenesis of acrokeratosis Bazex]

A 67-year-old male patient with typical signs of acrokeratosis Bazex is presented. The psoriasiform skin lesions appeared 9 months after diagnosis of an oesophagus neoplasm. Clinically there was a marked hepatopathy but no signs of metastases. Histological, immunofluorescence-histological, and ultrastructural findings revealed a capillaritis with humoral as well as cellular inflammation. With treatment of the neoplasm the paraneoplasia regressed under additional treatment with topical steroids. The vitamin A deficit could not be normalized by oral or parenteral vitamin A substitution. We discuss some mechanisms in formal pathogenesis.