Skin & Subcutaneous Tissue

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This 73-year-old lady has presented with multiple scaly and reddish patches on both hands and feet, along with keratoderma-like lesions on her palms and soles, and nail changes. Note that this type of symmetrical distribution confined to the peripheries is termed an \u0027acral\u0027 distribution.\n\nGiven the age of the patient and associated constitutional symptoms, acrokeratosis paraneoplastica (AP) is a serious concern. This is a paraneoplastic manifestation that is often secondary to an underlying gastrointestinal (GI) or pulmonary malignancy.\n\nWhen the significant history of smoking and recent-onset anorexia and dysphagia is also taken into account, the possibility of thus-undetected esophageal or gastric cancer should be kept in mind.\n\nOf course"}]}

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