Acanthosis nigricans: A presentation of gastric adenocarcinoma

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Journal Title, Volume, Page: 
Arab Journal of Gastroenterology, Volume 12-isue 3
Year of Publication: 
Yasser Abu-Safieh
Shadi Khelfa
Preferred Abstract (Original): 
A 29 year old female patient, presented with darkening of skin colour of one month duration, with initial involvement of the axillae, periumbilical region, and the neck, which then proceeded to involve the lips and periorbital skin. It was then treated by antifungal creams and oral antifungal agents, with no clinical improvement. The patient reported loss of weight in over 3 months, loss of appetite and some difficulty in swallowing, and then vomiting of coffee ground material, but denied melena. No polyuria or polydipsia were present. Past history revealed no previous illnesses and no drug allergy. Physical examination revealed normal vital signs and a tinge of jaundice. Abdominal examination revealed shifting dullness on percussion and hepatomegaly with no splenomegaly. The following skin areas were involved with variable degree of severity (most to less severe), axilla, lips, external genitalia, neck and periumbilical region. Skin was thickened, hyperpigmented, warty in the axillae (velvety skin), itchy in some of the described areas with minimal blood oozing from the lips. Consultation of the dermatologist confirmed the diagnosis of severe form of acanthosis nigricans with involvement of lips and mucous membranes (Fig. 1a and b).