Paraneoplastic Palmoplantar Keratoderma Secondary to Metastatic Uterine Adenocarcinoma
Palmoplantar keratoderma (PPK) is a dermatosis that presents as hyperkeratosis of the palms and soles. It may be acquired or heritable. Acquired PPK often occurs as a paraneoplastic response as well as a stigma of other dermatoses. We report a rare case of a 72-year-old woman with acquired PPK secondary to metastatic uterine adenocarcinoma. We also review other rare cases of cutaneous paraneoplasia secondary to uterine cancer and describe the salient features of acquired PPK. Acquired PPK most commonly presents as a paraneoplastic response to visceral malignancies that include localized esophageal, pulmonary, urinary/bladder, and gastric carcinomas, as well as myeloma. Management of acquired PPK includes treatment of the underlying cause. Adjunctive vitamin A analogues have been found to be effective.
Practice Points
- Paraneoplastic palmoplantar keratoderma (PPK) is an acquired dermatosis that presents with hyperkeratosis of the palms and soles in association with visceral malignancies (eg, esophageal, gastric, pulmonary, and urinary/bladder carcinomas).
- Palmoplantar keratoderma secondary to uterine cancer is rare.
- Light microscopy shows thickening of any or all of the cell layers of the epidermis (hyperkeratosis, acanthosis, and papillomatosis) and mononuclear cells.
- Management of acquired PPK includes treatment of the underlying malignancy. Adjunctive vitamin A analogues may be of additional utility.
