Title : Bazex syndrome–like paraneoplastic acrokeratosis
Abstract:
Background: Bazex syndrome is a rare paraneoplastic acrokeratosis, most commonly associated with squamous cell carcinomas of the upper aerodigestive tract. Cutaneous manifestations may precede the diagnosis of malignancy and are often resistant to conventional dermatologic treatment.
Case Presentation: We report a 61-year-old man with widespread hyperkeratotic plaques in a Blaschkoid distribution, involving the palms, soles, ears, and tip of the nose. Histopathology showed features of a lichenoid drug eruption, while FNAC of a long-standing cervical swelling revealed epithelial malignancy. CECT imaging demonstrated multiple liver lesions suggestive of metastases, and CECT neck suggested lymphomatous involvement or metastases from a head-and-neck primary. Upper gastrointestinal endoscopy was unremarkable.
Results: This case represents an unusual presentation of Bazex-like cutaneous lesions extending beyond classic acral sites, emphasizing the importance of systemic evaluation when histopathology is non-specific.
Conclusion: Clinicians should recognize Bazex syndrome as a potential early marker of occult malignancy. Extensive or atypical skin involvement, even when histopathology is ambiguous, warrants prompt and thorough malignancy screening.
