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Acrokeratosis paraneoplastica is an extremely rare syndrome typically involving men over the age of 40 years with an aerodigestive tract cancer.
Acrokeratosis paraneoplastica typically occurs in three stages based on tumor progression.
Acrokeratosis paraneoplastica involves bilateral psoriasiform cutaneous lesions that initially present on acral surfaces, especially the ears, nose, hands, and feet, spreading centripetally [2, 4, 5].
Many psoriasiform dermatoses, such as erythroderma, pityriasis rubra pilaris, acrokeratosis paraneoplastica, and the nutritional deficiency dermatitides, always affect other body sites when they affect the face, and thus, they do not appear in facial biopsies.
The most common skin paraneoplastic manifestations are acanthosis nigricans, erythromelalgia, thrombotic thrombocytopenic purpura, acrokeratosis paraneoplastica, paraneoplastic hypertrichosis lanuginosa acquisita, dermatomyositis, systemic sclerosis, and scleroderma [11-13].