手指の疣状結節を伴った黒色表皮腫

・手指の疣状局面から黒色表皮腫の診断に至った．

・診断後に全身検索を行い，3型進行胃癌が発見された．

（「症例のポイント」より）

　

Acanthosis nigricans accompany with verucca on fingers

　

Kikuchi, Hitomi1）Akashiba, Tomomi1）Kurita, Takayuki1）Ishii, Ken1）Higo, Naotaka1）Ishiko, Akira1） 1）Department of Dermatology, Toho University Omori Medical Center

　

66-year-old man was referred to us with the chief complaint of eruption on the dorsa of the hands that appeared half year before. Partially fused small papules were seen. In addition, his face and neck showed brown pigmentation, and black velvety rough surfaced skin were seen on the axillae, the back, and the genital area. Skin biopsies were taken from the right axilla and left ring finger. The histopathology of the axilla showed papillomatosis, mild acanthosis, and basal pigmentosis in the epidermis. The specimen from the finger showed hyperkeratosis and papillomatosis that was compatible with “tripe palm”. He was diagnosed as having acanthosis nigricans and advanced gastric cancer was found by endoscopy. Tripe palm is a skin symptom closely related to the acanthosis nigricans and it may serve as a clue to find internal malignancy.