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Tripe palms
Tripe palms
Specialty	Dermatology
Causes	Paraneoplastic syndrome
Diagnostic method	Appearance
Frequency	Rare

Tripe palms, also known as acanthosis palmaris, is a medical sign characterized by thick ridged velvety palms, typically as part of a paraneoplastic syndrome.^[1] It resembles the lining of the stomach of some animals (tripe).^[2] Other signs that may be noted at the same time include most frequently acanthosis nigricans (AN), and less commonly finger clubbing and Leser-Trélat sign.^[2]

The sign is rare.^[3]

Signs and symptoms

Tripe palms appear as thick ridged velvety palms, typically as part of a paraneoplastic syndrome.^[1]

Cause and mechanism

How it occurs is unclear.^[3] More than 90% of individuals with the sign have a cancer.^[1]^[2] In some, both tripe palms and AN appear together before the cancer is diagnosed.^[3] Lung cancer is more frequent if the tripe palms present alone, whereas cancer of the stomach is more frequent when AN is also present.^[1] The sign has also been associated with bullous pemphigoid, psoriasis, and exfoliative dermatitis.^[2] It is believed that growth factors secreted by cancer cells cause some skin cells to grow.^[3]

Diagnosis and treatment

Diagnosis is by its appearance and a biopsy is generally not helpful.^[2] Other conditions that may appear similar include acromegaly, acrokeratosis paraneoplastica, hypertrophic osteoarthropathy, idiopathic hypertrophic osteoarthropathy, palmoplantar keratoderma, and acropachy.^[2] Tripe palms may improve with treatment of the underlying cancer.^[3]

Epidemiology

The sign is rare.^[3] There are around 100 reported cases worldwide.^[2]

History

The term was first coined by Jacqueline Clarke in 1977.^[4]^[5]

References

^ ^a ^b ^c ^d ^e ^f ^g James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "24. Endocrine diseases". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Elsevier. p. 503. ISBN 978-0-323-54753-6.
^ ^a ^b ^c ^d ^e ^f ^g "Tripe Palms - DermNet". dermnetnz.org. Retrieved 1 August 2023.
^ ^a ^b ^c ^d ^e ^f Fonia, Athina; Baran, Robert (2021). "Cutaneous paraneoplastic syndromes with nail involvement". In Lipner, Shari (ed.). Nail Disorders: Diagnosis and Management, An Issue of Dermatologic Clinics. Elsevier. p. 179. ISBN 978-0-323-70924-8.
^ Clarke, Jacqueline (June 1977). "Malignant acanthosis nigricans". Clinical and Experimental Dermatology. 2 (2): 167–170. doi:10.1111/j.1365-2230.1977.tb01561.x. PMID 884896.
^ Niederhuber, John E. (1993). Current Therapy in Oncology. B.C. Decker. ISBN 978-1-55664-229-6.