Malignant Acanthosis Nigricans, Sign of Leser–Trélat, and Tripe Palms

Abstract

Clinical signs and features include:

Malignant acanthosis nigricans, sign of Leser–Trélat, and tripe palms are often found together

Malignant acanthosis nigricans is rare: in total, worldwide, only 1,000 reported cases

Involves symmetric hyperpigmented plaques with variable amounts of epidermal hypertrophy, creating a velvety texture; ranges in color from yellow to gray/black; often has overlying scaling/papillomas (if extensive then cutaneous papillomatosis)

Progressive—generally advances with cancer, begins with increased pigmentation and advances to hypertrophy with accentuation of the skin lines; maybe associated with pruritus

Most commonly found on flexural areas, posterior neck, or mucosally (particularly the mouth)