A Case of Bazex Syndrome

Paraneoplastic syndromes refer to the remote effects of underlying neoplasms mediated by hormones, peptides, or cytokines. A 77-year-old man with lifestyle-related diseases presented to the internal medicine department with a 2month history of itchy skin lesions on his palms and soles. The palm side of all digits was velvety and thickened, and the soles had scales accompanied by erythema (Picture 1). As his Brinkman index exceeded 1,000, we suspected Bazex syndrome associated with lung cancer, which was confirmed by computed tomography (Picture 2). The skin lesions disappeared within four months after surgical resection of the tumor (Picture 3). Bazex syndrome, often accompanied by aerodigestive tract malignancy, is a paraneoplastic syndrome characterized by symmetrical erythematous scaly lesions over the acral extremities (1). The etiology is presumed to be immunological, and the common histopathology is psoriasiform. Differential diagnoses include psoriasis and contact dermatitis. The lesion is resistant to conventional treatment; however, surgical excision of the tumor is effective (2).