Acanthosis palmaris: tripe palms. a distinctive pattern of palmar keratoderma frequently associated with internal malignancy

Abstract

We describe five patients who showed a distinctive pattern of late onset hyperkeratosis and acanthosis of palms and fingers. The epidermal thickening gave rise to a rugose appearance with broadened rete ridges bounded by deep sulci (tripe palms). One of these patients had malignant acanthosis nigricans, two also had carcinomata with the palmar changes as a forme fruste of acanthosis nigricans and two patients had pruriginous dcrmatoses with palmar changes of diffuse lichenification which were reversible. The relationship between palmar‐plantar keratoderma and malignancy is discussed.