Tripe palms, also known as acanthosis palmaris, is a

medical sign Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

characterized by thick ridged velvety palms, typically as part of a

paraneoplastic syndrome A paraneoplastic syndrome is a syndrome (a set of signs and symptoms) that is the consequence of a tumor in the body (usually a cancerous one). It is specifically due to the production of chemical signaling molecules (such as hormones or cytokin ...

. It resembles the lining of the stomach of some animals (

tripe Tripe is a type of edible lining from the stomachs of various farm animals. Most tripe is from cattle and sheep. Types Beef Beef tripe is made from the muscle wall (the interior mucosal lining is removed) of a cow's stomach chambers: th ...

). Other signs that may be noted at the same time include most frequently

acanthosis nigricans Acanthosis nigricans is a medical sign characterised by brown-to-black, poorly defined, velvety hyperpigmentation of the skin. It is usually found in body folds, such as the posterior and lateral folds of the neck, the armpits, groin, navel, foreh ...

(AN), and less commonly finger clubbing and Leser-Trélat sign. The sign is rare.

Signs and symptoms

Tripe palms appear as thick ridged velvety palms, typically as part of a

Cause and mechanism

How it occurs is unclear. More than 90% of individuals with the sign have a cancer. In some, both tripe palms and AN appear together before the cancer is diagnosed. Lung cancer is more frequent if the tripe palms present alone, whereas

cancer of the stomach Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

is more frequent when AN is also present. The sign has also been associated with

bullous pemphigoid Bullous pemphigoid (a type of pemphigoid) is an autoimmune pruritic skin disease that typically occurs in people aged over 60, that may involve the formation of blisters ( bullae) in the space between the epidermal and dermal skin layers. It is ...

psoriasis Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by patches of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small localized patches to complete b ...

, and exfoliative dermatitis. It is believed that growth factors secreted by cancer cells cause some skin cells to grow.

Diagnosis and treatment

Diagnosis is by its appearance and a biopsy is generally not helpful. Other conditions that may appear similar include

acromegaly Acromegaly is a disorder that results in excess growth of certain parts of the human body. It is caused by excess growth hormone (GH) after the growth plates have closed. The initial symptom is typically enlargement of the hands and feet. There ...

acrokeratosis paraneoplastica Paraneoplastic acrokeratosis is a skin condition characterized by psoriasiform changes of fingers, toes, ears, and nose, with involvement of the nails and periungual tissues being characteristic and indistinguishable from psoriatic nails. The c ...

hypertrophic osteoarthropathy Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component Cell (biology), cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number. Al ...

, idiopathic hypertrophic osteoarthropathy,

palmoplantar keratoderma Palmoplantar keratodermas are a heterogeneous group of skin disorders characterized by abnormal thickening (scleroderma) of the stratum corneum of the palms and soles. Autosomal recessive, dominant, X-linked, and acquired forms have all been de ...

, and acropachy. Tripe palms may improve with treatment of the underlying cancer.

Epidemiology

The sign is rare. There are around 100 reported cases worldwide.

History

The term was first coined by Jacqueline Clarke in 1977.

References