Tripe palm and malignant acanthosis nigricans in metastatic endometrial adenocarcinoma

Acanthosis nigricans (AN) is a dermatologic condition characterized by velvety hyperpigmented plaques in intertriginous areas, with benign and malignant forms exhibiting distinct etiologies. Benign AN is linked to genetic, endocrine, and obesity-related factors, while malignant AN is recognized as a paraneoplastic syndrome associated with internal malignancies, notably gastric adenocarcinomas. This case presents a 57-year-old female with metastatic endometrial adenocarcinoma and concurrent generalized AN, including palmar involvement (Tripe palms). The atypical presentation, involving uncommon sites like palms, raises suspicion of malignancy-associated AN. Proposed pathogenesis involves tumor-produced cytokines stimulating skin cells. Histologically nonspecific, malignant AN exhibits hyperkeratosis and papillomatosis. Management primarily addresses the underlying malignancy, highlighting the intricate link between dermatologic manifestations and systemic conditions. The case underscores the need for interdisciplinary collaboration in patient care, emphasizing the significance of recognizing cutaneous signs as potential paraneoplastic syndromes. Continued oncology follow-up is crucial. Overall, this case illuminates the complex interplay between dermatology and systemic health, emphasizing the importance of a comprehensive approach to patient management.