Tripe palms
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 symptomsTripe palms appear as thick ridged velvety palms, typically as part of a paraneoplastic syndrome.[1] Cause and mechanismHow 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 treatmentDiagnosis 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] EpidemiologyThe sign is rare.[3] There are around 100 reported cases worldwide.[2] HistoryThe term was first coined by Jacqueline Clarke in 1977.[4][5] See alsoReferences
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