Malignant acanthosis nigricans with Leser–Trélat sign and tripe palms:A case report

BACKGROUND Acanthosis nigricans(AN),Leser–Trélat sign,and tripe palm are all skin diseases.To date,reports of these appearing as a paraneoplastic syndrome in a gastric cancer patient are quite rare.CASE SUMMARY We report the case of a 61-year-old man with darkened skin color in the face and torso with no obvious inducement after 1 year of treatment for Riehl’s melanosis.He had 40 brown maculopapular eruptions on his face and the top of his head with obvious itching.Papillary wart-like hyperkeratosis with dark brown pigmentation was also observed on both sides of the areola.He had papillomalike lesions on the face,around the orbit,and on the neck.His bilateral palms had small,smooth,papillary projections with millet-like appearance.Histopathological examination of the skin showed that the patient was suffering from AN,tripe palms,and Leser–Trélat sign.Gastroscopy showed the patient’s cardia was affected,and pathological biopsy revealed that he had moderate-to-poorly differentiated adenocarcinoma.Computed tomography test results showed that his cardia wall had thickened.Based on these histological and skin characteristics,the patient was diagnosed with gastric cancer with AN,tripe palms,and Leser–Trélat sign.CONCLUSION Researchers should follow up on patients with malignant AN,Leser–Trélat sign,and tripe palms.

Oral malignant acanthosis nigricans associated with endometrial adenocarcinoma

We report a 59-year-old patient with malignant acanthosis nigricans associated with metastasis of endometrial carcinoma. The patient presented papillomatosis lesions that appeared to be benign on multiple skins of body folds, particularly on lips. The lesions in lips and axilla had histological characteristic appearances of acanthosis nigricans, while the masses in abdomen and pelvis were metastasis endometrial adenocarcinoma. The article highlights the importance of biopsy and histopathological diagnosis in presumed benign lesions and the role of doctors in screening for body internal tumors.

Coexistence of ovarian serous papillary cystadenofibroma and type A insulin resistance syndrome in a 14-year-old girl: A case report

BACKGROUND Type A insulin resistance syndrome is a rare disorder caused by mutations in the gene encoding the insulin receptor.Its coexistence with ovarian serous papillary cystadenofibroma is even rarer.CASE SUMMARY A 14-year-old girl developed type A insulin resistance syndrome and showed high fasting insulin,glucose,and hemoglobin A1c(HbA1c)levels.The girl suffered from ovarian serous papillary cystadenofibroma.The laboratory results were as follows:fasting insulin was 2624.90 pmol/L and HbA1c was 8.5%.A heterozygous missense mutation on exon 20 of the insulin receptor gene(c.3601C>T,Arg1201Trp)was observed.The histopathological diagnosis was a cystic lesion that extended to the upper right uterus,indicating a right ovarian serous papillary cystadefibroma accompanied by focal interstitial hyperplasia.The patient was treated with metformin for over 6 mo.Additionally,laparoscopic resection(bilateral)of the ovarian lesion and laparoscopic intestinal adhesiolysis were performed under general anesthesia.Diet therapy combined with exercise was then initiated.The patient had an uneventful recovery.The patient also showed improved blood glucose control,with reduced levels of fasting insulin(857.84 pmol/L)and HbA1c(7.0%).CONCLUSION Insulin resistance may play a significant role in the induction of tumors.It is important to investigate further the association between insulin resistance and tumors and the underlying mechanism.

Diagnostic Sign of Terra Firma-Forme Dermatosis

Background: Terra Firma-Forme Dermatosis (TFFD), a benign skin condition which presents with asymptomatic brown to black plaques which resemble dirty skin. Aim: To document a new case presentation with TFFD in the Arab region which is considered as one of the differential diagnoses of dirty neck. Case presentation: A 15-year-old girl presented with a history of asymptomatic brownish dirt-like lesion on the nape and sides of the neck for 4-years duration, not resolved by wash with water and soap and confused with other dermatoses like acanthosis nigricans or atopic dermatitis. The diagnosis of TFFD was confirmed when the lesions were completely resolved after gentle swabbing with 70% isopropyl alcohol. Conclusion: TFFD is rarely reported in Arab region and should be considered when evaluating cases of dirty neck-like presentation of atopic dermatitis or acanthosis nigricans.