Acquired Diffuse Keratoderma of the Palms and Soles With Bronchial Carcinoma: Report of a Case and Review of the Literature

To the Editor.— There have been some reports of internal malignancy associated with nonfamilial palmoplantar keratoderma of late onset, 1-4 as well as of esophageal squamous cell carcinoma in association with familial keratosis palmaris et plantaris of early onset. 5 We describe a patient who had developed nonfamilial, acquired diffuse palmoplantar keratoderma of late onset as a cutaneous manifestation of primary bronchial carcinoma. A review of the literature on similar cases 1-4 disclosed a possible relationship between late-onset, nonfamilial palmoplantar keratoderma and intrathoracic squamous cell carcinoma. Report of a Case.— A 49-year-old man presented to our clinic in June 1985, with a three-month history of progressive thickening of his palms and soles. Physical examination revealed diffuse keratoderma of both palms and soles with dry, thick, and yellowish scales (Figure). Repeated microscopic examinations and cultures of scales for fungi gave negative findings. A skin biopsy specimen obtained from the palmar skin