Paraneoplastic acrokeratosis of Bazex

Paraneoplastic acrokeratosis of Bazex is a symmetrical dermatosis which most commonly affects the hands, feet, ears, and nose with an erythematous psoriasiform eruption.
The eruption is of a bluer hue than is psoriasis.
Later changes involve the cheeks, elbows and knees, with still later changes often involving the central trunk where bullae may be seen.
The nails are involved early, and severely. There is subungual hyperkeratosis, as well as a flaky white surface to the nail. The nails may be shed.
The distal digits show an erythematous scaling eruption, often fissured, and often with suppuration.
This syndrome is usually associated with neoplasia of the upper respiratory system, which includes tongue, pharynx, esophagus, and lung.
Acanthosis nigricans may be an associated finding.

Treatment:

• Bazex syndrome has been reported to respond to etretinate, even though the primary lesion was left untreated.

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