The authors discuss the main features of paraneoplastic acro keratosis, a new cutaneous marker of malignancy. Clinically, the condition begins at the extremities of the limbs and spreads upwards secondarily. The eruption is psoriasis-like squamous erythema of the face, hands and feet. Nail changes are present from the onset. These lesions are always associated with a malignant epithelioma, usually of the spino-cellular type localised in the upper respiratory and digestive tracts. Surgical cure of the primary malignant tumour leads to regression of the skin lesions which reappear in case of relapse.
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