Kiyoshi Shikino, MD, PhD, Tsutomu Mito, MD, Yusuke Hirota, MD, Masatomi Ikusaka, MD, PhD
May 22, 2017
An 84-year-old man presented with a 2-month history of painful skin lesions on his hands, feet, and ears. He had a smoking history of 3 packs/day for 60 years. His past medical history included hypertension treated with angiotensin II receptor antagonists. He had no personal or family history of cancer, and had never had age-appropriate cancer screening.His dermatologist had suspected frostbite, but eight weeks of treatment with clobetasol cream had been unsuccessful. He also reported dysphagia, odynophagia, and weight loss for 3-months. Physical examination revealed hyperkeratotic plaques on the hands and soles with blistering (See Figure 1a, 1b), and violet, infiltrative, desquamative erythematous plaques on the ears and nose (See Figure 2a, 2b). Laboratory data was within normal range. Electronic laryngoscopy revealed a paralyzed right true vocal cord and right arytenoid, with a large submucosal mass in the right false vocal cord and right arytenoids. Microscopic examination of fine-needle aspiration was taken from the mass.
Click here to view answer
References
1. Zhao J, Zhang X, Chen Z, Wu JH. Case Report: Bazex Syndrome Associated With Pulmonary Adenocarcinoma. Medicine 2016; 95(2): e2415.
2. Silva JA, Mesquita Kde C, Igreja AC, et al. Paraneoplastic cutaneous manifestations: concepts and updates. An Bras Dermatol 2013; 88(1): 9-22.
Authors:
1. Kiyoshi Shikino, MD, PhD is Project Assistant Professor of the Department of General Medicine at Chiba University Hospital in Japan.
2. Tsutomu, MD is a Clinical Fellow of the Department of General Medicine at Chiba University Hospital in Japan.
3. Yusuke Hirota, MD is Project Assistant Professor of the Department of General Medicine at Chiba University Hospital in Japan.
4. Masatomi Ikusaka, MD, PhD is a Professor of the Department of General Medicine at Chiba University Hospital in Japan.