Palmar Spiny Keratoderma Preceding the Diagnosis of Mycosis Fungoides: A New Paraneoplastic Association?

Abstract

Spiny keratoderma is a rare dermatosis of unknown etiology that has been described with both hereditary and acquired variants. The acquired form has been associated with underlying malignancy and systemic diseases. We report a case of a 65-year- -old caucasian male presenting with multiple filiform hyperkeratotic papules in the palmar aspect of his hands which were present for the past year. Skin biopsy revealed aspects compatible with spiny keratoderma. After 10 months of follow-up, the patient developed mycosis fungoides, staged as IB according to the European Organization for Research and Treatment of Cancer and treated with PUVAtherapy with good control of both dermatosis. The authors raise the hypothesis of a new paraneoplastic association of spiny keratoderma.