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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An 82-year-old man presented yellow keratotic papules on the palms and soles&#44; which appeared 5 years earlier&#46; There were no associated personal antecedents of interest&#44; except for chronic abdominal pain&#46; The examination revealed nonconvergent punctate keratotic papules &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; on the palms and soles&#44; a number of them inverted and painful when pressed&#46; Histopathology showed compact columns of hyperkeratosis and hypergranulosis&#44; with no signs of inflammation in the dermis and no cornoid lamella&#46; The diagnosis was compatible with punctate palmoplantar keratoderma&#46; We conducted an extension study using blood tests&#44; abdominal computed tomography and gastrointestinal endoscopy&#44; whose findings were compatible with colon adenocarcinoma&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Punctate palmoplantar keratodermas can be hereditary&#44; and their lesions appear in adolescence&#44; where Buschke&#8211;Fischer&#8211;Brauer type I is the most common&#46; The acquired forms are secondary to arsenic exposure or paraneoplastic&#44; as was the case with our patient&#46; Colon adenocarcinoma is the malignant tumor most commonly associated with this condition&#44; although the condition has also been associated with Hodgkin&#39;s lymphomas&#44; kidney and pancreatic adenocarcinoma and breast cancer&#44; among others&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Treatment with topical keratolytic agents and oral retinoids presents highly varied results&#46; In paraneoplastic cases&#44; complete resolution of the tumor is not always associated with clinical improvement of the lesions&#46;</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&#46;</p></span>"
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Medicine in Images
DOI: 10.1016/j.rceng.2018.12.011
Yellow keratotic palmoplantar papules and chronic abdominal pain
Pápulas amarillas queratósicas palmoplantares y dolor abdominal crónico
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F.J. Navarro-Triviño
Corresponding author
fntmed@gmail.com

Corresponding author.
, R. Ruíz-Villaverde
Servicio de Dermatología y Venereología, Hospital Universitario San Cecilio, Granada, Spain

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Revista Clínica Española
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