Indurated reticulate palmar erythema as a sign of paraneoplastic palmar fasciitis and polyarthritis syndrome

Australas J Dermatol. 2009 Aug;50(3):198-201. doi: 10.1111/j.1440-0960.2009.00538.x.

Abstract

A 62-year-old woman presented with a 6-month history of polyarthritis. She had also noted a 2-month history of indurated palmar erythema and increasing bilateral hand swelling and stiffness. A biopsy from the area of palmar erythema showed interstitial fibroplasia within the dermis and subcutis representing a palmar fibromatosis. This presentation appears to belong to the spectrum of palmar fasciitis and polyarthritis syndrome. Rheumatologists have recognised this syndrome as a paraneoplastic disorder and subsequent investigations in our patient revealed an elevated cancer antigen 125 and an inoperable ovarian carcinoma. Indurated palmar erythema is a sign that is not widely recognised by dermatologists as a clue for this paraneoplastic syndrome, and skin biopsy demonstrating dermal and subcutaneous fibroplasia may help in diagnosis in the absence of advanced signs of palmar fasciitis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / therapy
  • Arthritis / complications
  • Arthritis / diagnosis*
  • Arthritis / drug therapy
  • Biopsy, Needle
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Erythema / complications
  • Erythema / diagnosis*
  • Erythema / drug therapy
  • Fasciitis / complications
  • Fasciitis / diagnosis*
  • Fasciitis / therapy
  • Female
  • Follow-Up Studies
  • Hand Dermatoses / complications
  • Hand Dermatoses / diagnosis
  • Hand Dermatoses / drug therapy
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / therapy
  • Paraneoplastic Syndromes / diagnosis
  • Paraneoplastic Syndromes / pathology*
  • Paraneoplastic Syndromes / therapy
  • Risk Assessment
  • Treatment Outcome