Acquired pachydermatoglyphia: the cutaneous manifestation of pulmonary tumours

Description

A 74-year-old man with active smoking habits presented to the emergency department with a 2-month history of weight loss (20% of previous body mass), dyspnoea and night sweats. Physical examination showed clinical signs of respiratory distress, significant cachexia and thickened velvety palms with pronounced folds (figure 1). The laboratory results revealed leucocytosis of 15 700 cells/µl, thrombocytosis of 547 000/µl and elevated C reactive protein of 6.65 mg/dL. A posteroanterior chest radiograph showed a right pleural effusion and consolidation suggestive of pneumonia.

Figure 1

Thickened velvety palms with pronounced folds consistent with acquired pachydermatoglyphia.

The patient was given antibiotics and submitted to pleural effusion drainage for symptomatic relief. A skin biopsy of the palms was obtained and the histopathological examination identified signs of hyperkeratosis, acanthosis and papillomatosis consistent with acquired pachydermatoglyphia (figure 2).

Figure 2

Skin biopsy consistent with acquired...

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