Tripe palms

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Tripe palms
Other names: Acquired pachydermatoglyphia[1]
Tripe palms (DermNet NZ systemic-tripe-palms).jpg
Tripe palms
SpecialtyDermatology
SymptomsThick ridged velvety palms[2]
CausesCancer[2]
Diagnostic methodVisualisation[2]
Differential diagnosisAcromegaly, acrokeratosis paraneoplastica, hypertrophic osteoarthropathy, idiopathic hypertrophic osteoarthropathy, palmoplantar keratoderma, acropachy[1]
TreatmentTreat underlying cancer[3]
FrequencyRare[3]

Tripe palms, also known as acanthosis palmaris, is a medical sign characterized by thick ridged velvety palms, typically as part of a paraneoplastic syndrome.[2] It resembles the lining of the stomach of some animals (tripe).[1] Other signs that may be noted at the same time include most frequently acanthosis nigricans (AN), and less commonly finger clubbing and Leser-Trélat sign.[1]

How it occurs is unclear.[3] More than 90% of individuals with the sign have a cancer.[1][2] In some, both tripe palms and AN appear together before the cancer is diagnosed.[3] Lung cancer is more frequent if the tripe palms present alone, whereas cancer of the stomach is more frequent when AN is also present.[2] The sign has also been associated with bullous pemphigoid, psoriasis, and exfoliative dermatitis.[1] It is believed that growth factors secreted by cancer cells cause some skin cells to grow.[3]

Diagnosis is by its appearance and a biopsy is generally not helpful.[1] Other conditions that may appear similar include acromegaly, acrokeratosis paraneoplastica, hypertrophic osteoarthropathy, idiopathic hypertrophic osteoarthropathy, palmoplantar keratoderma, and acropachy.[1] The sign may improve with treatment of the underlying cancer.[3]

The sign is rare.[3] There are around 100 reported cases worldwide.[1] The term was first coined by Jacqueline Clarke in 1977.[4][5]

Signs and symptoms

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 "Tripe Palms - DermNet". dermnetnz.org. Archived from the original on 7 June 2023. Retrieved 1 August 2023.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "24. Endocrine diseases". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Elsevier. p. 503. ISBN 978-0-323-54753-6. Archived from the original on 2023-08-02. Retrieved 2023-08-01.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Fonia, Athina; Baran, Robert (2021). "Cutaneous paraneoplastic syndromes with nail involvement". In Lipner, Shari (ed.). Nail Disorders: Diagnosis and Management, An Issue of Dermatologic Clinics. Elsevier. p. 179. ISBN 978-0-323-70924-8. Archived from the original on 2023-08-02. Retrieved 2023-08-01.
  4. Clarke, Jacqueline (June 1977). "Malignant acanthosis nigricans". Clinical and Experimental Dermatology. 2 (2): 167–170. doi:10.1111/j.1365-2230.1977.tb01561.x. PMID 884896. Archived from the original on 2023-08-02. Retrieved 2023-08-01.
  5. Niederhuber, John E. (1993). Current Therapy in Oncology. B.C. Decker. ISBN 978-1-55664-229-6. Archived from the original on 2023-08-02. Retrieved 2023-08-01.