Medicine in Images
Yellow keratotic palmoplantar papules and chronic abdominal pain
Pápulas amarillas queratósicas palmoplantares y dolor abdominal crónico
F.J. Navarro-Triviño
, R. Ruíz-Villaverde
Corresponding author
Servicio de Dermatología y Venereología, Hospital Universitario San Cecilio, Granada, Spain
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Navarro-Triviño, R. Ruíz-Villaverde" "autores" => array:2 [ 0 => array:4 [ "nombre" => "F.J." "apellidos" => "Navarro-Triviño" "email" => array:1 [ 0 => "fntmed@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Ruíz-Villaverde" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología y Venereología, Hospital Universitario San Cecilio, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápulas amarillas queratósicas palmoplantares y dolor abdominal crónico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 930 "Ancho" => 1354 "Tamanyo" => 147857 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An 82-year-old man presented yellow keratotic papules on the palms and soles, which appeared 5 years earlier. There were no associated personal antecedents of interest, except for chronic abdominal pain. The examination revealed nonconvergent punctate keratotic papules (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) on the palms and soles, a number of them inverted and painful when pressed. Histopathology showed compact columns of hyperkeratosis and hypergranulosis, with no signs of inflammation in the dermis and no cornoid lamella. The diagnosis was compatible with punctate palmoplantar keratoderma. We conducted an extension study using blood tests, abdominal computed tomography and gastrointestinal endoscopy, whose findings were compatible with colon adenocarcinoma.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Punctate palmoplantar keratodermas can be hereditary, and their lesions appear in adolescence, where Buschke–Fischer–Brauer type I is the most common. The acquired forms are secondary to arsenic exposure or paraneoplastic, as was the case with our patient. Colon adenocarcinoma is the malignant tumor most commonly associated with this condition, although the condition has also been associated with Hodgkin's lymphomas, kidney and pancreatic adenocarcinoma and breast cancer, among others.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Treatment with topical keratolytic agents and oral retinoids presents highly varied results. In paraneoplastic cases, complete resolution of the tumor is not always associated with clinical improvement of the lesions.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The age at onset of the lesions and the proper anamnesis of systemic symptoms are key factors when detecting cases of paraneoplastic origin.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-12-16" "fechaAceptado" => "2018-12-28" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Navarro-Triviño FJ, Ruíz-Villaverde R. Pápulas amarillas queratósicas palmoplantares y dolor abdominal crónico. Rev Clin Esp. 2020;220:317–318.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 930 "Ancho" => 1354 "Tamanyo" => 147857 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022000000005/v1_202006100751/S2254887419301018/v1_202006100751/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000005/v1_202006100751/S2254887419301018/v1_202006100751/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419301018?idApp=WRCEE" ]
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