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Malignant Acanthosis Nigricans with Stomach Adenocarcinoma and Esophageal Paailloma
Sen-An Yang, Hamm-Ming Sheu, Li-Tzong Chen, Hsin-Su Yu, Chang-Yi Chen
Dermatol Sinica 8: 23-29, 1990

We herein report a typical case of acanthosis nigricans (AN). A 74-year-old male patient suffered from pigmented and velvety skin changes on the neck, axilla and inguinal area for half a year. Disseminated florid cutaneous papillomatosis were noted on the whole body. After a series of examinations, adenocarcinoma of the stomach and papilloma of the esophagus were found. After receiving chemotherapy for three months, florid cutaneous papillomatosis made marked improvements. The size of adenocarcinoma of the stomach and the number of papilloma of the esophagus reduced respectively.Besides, the examination of cytokeratins of skin and esophagus was performed. The results showed obvious differences between the skin of normal control and the AN patient in K8.12 (cytokeratin 13,16). The presence of cytokeratins 13,16 at suprabasal layer on the papillomatous skin may represent an epidermal hyperproliferative changes. However, there was no difference between the esophagus of normal control and papilloma of the AN patient in cytokeratin research.Malignant AN is a paraneoplastic disorder of the skin and oral mucosa. Awareness of the possible association of AN and florid cutaneous papillomatosis with an underlying neoplasm may lead to early diagnosis and treatment of the occult cancer.

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