Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Practice

Bazex syndrome

Kiyoshi Shikino and Masatomi Ikusaka
CMAJ May 01, 2017 189 (17) E639; DOI: https://doi.org/10.1503/cmaj.160912
Kiyoshi Shikino
Department of General Medicine, Chiba University Hospital, Chiba, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: kshikino@gmail.com
Masatomi Ikusaka
Department of General Medicine, Chiba University Hospital, Chiba, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

An 84-year-old man with a 180-pack-year smoking history presented with a two-month history of skin lesions on his hands, feet, ears and nose. The cutaneous lesions were painful and well delimited. Eight weeks’ treatment with clobetasol cream had been unsuccessful. The patient also reported dysphagia, odynophagia and weight loss (8 kg in three months). We characterized his skin lesions as symmetric hyperkeratotic plaques involving the distal part of his hands and feet (Figure 1). He had yellow fingernails, which were proximally detached. His ears and nose had violaceous desquamation (Figure 2). Computed tomography showed a mass in the right parapharyngeal space and enlarged cervical lymph nodes on the right side. Microscopic examination of fine-needle aspiration of the mass was consistent with a diagnosis of poorly differentiated laryngeal squamous cell carcinoma (tumour stage 4a, lymph node stage 2c, no distant metastasis). We diagnosed his skin condition as a paraneoplastic condition known as Bazex syndrome, based on the new onset of typical skin findings associated with the tumour. This diagnosis was confirmed when the skin lesions resolved after three weeks of radiation therapy to the mass.1 There was no recurrence of skin lesions at six-month follow-up.

Figure 1:
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1:

Symmetric hyperkeratotic plaques on the distal part of the hands and feet of an 84-year-old man.

Figure 2:
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 2:

Violaceous desquamation of the patient’s ears (hearing aid in place).

Bazex syndrome is frequently associated with squamous cell carcinomas of the upper aerodigestive tract.1,2 Although its pathophysiology is unknown, an association with bladder, breast and gynecological cancers has also been reported.1,2 This paraneoplastic skin condition usually precedes a cancer diagnosis by two to six months. It is characterized by symmetric desquamative erythema with bluish or violet discoloration, onychodystrophy or keratoderma.1,2 The differential diagnosis includes psoriasis.1 Lesions are typically located on the fingers, toes, ears and nose.1,2 Resistance to conventional treatments, including steroids, may alert physicians to an underlying malignant tumour.1 In most cases, improvement occurs after treatment of the primary tumour.1

Footnotes

  • Competing interests: None declared.

  • This article has been peer reviewed.

  • The authors have obtained patient consent.

References

  1. ↵
    1. Silva JA,
    2. de Mesquita KC,
    3. Igreja AC,
    4. et al
    . Paraneoplastic cutaneous manifestations: concepts and updates. An Bras Dermatol 2013;88:9–22.
    OpenUrl
  2. ↵
    1. Hempen A,
    2. Samartzis EP,
    3. Kamarachev J,
    4. et al
    . Acrokeratosis paraneoplastica in serous ovarian carcinoma: case report. BMC Cancer 2015;15:507.
    OpenUrl
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 189 (17)
CMAJ
Vol. 189, Issue 17
1 May 2017
  • Table of Contents
  • Index by author

Article tools

Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Bazex syndrome
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Bazex syndrome
Kiyoshi Shikino, Masatomi Ikusaka
CMAJ May 2017, 189 (17) E639; DOI: 10.1503/cmaj.160912

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Bazex syndrome
Kiyoshi Shikino, Masatomi Ikusaka
CMAJ May 2017, 189 (17) E639; DOI: 10.1503/cmaj.160912
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Prostatic abscess
  • Relapsing fever in a traveller returning from Senegal
  • Orbital floor fracture
Show more Practice

Similar Articles

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of the resources on this site in an accessible format, please contact us at cmajgroup@cmaj.ca.

Powered by HighWire