Bizarre rash on woman’s hand was rare warning sign of cancer, docs discover
A WOMAN with a bizarre rash on her hands was shocked to discover it was a rare warning sign of cancer.
The 73-year-old, from Sao Paulo, Brazil, went to see a doctor after breaking out in painful, itchy marks on her palms.
She told medics that they first appeared around nine months ago and in the last four months she had lost 11lbs (5kg).
They carried out a physical examination confirming the sharp folds in the lines of her hands as well as a "velvety appearance".
Doctors writing in a case report, published in the New England Journal of Medicine, said: "Physical examination revealed sharp demarcation of the folds in the lines of her hands in addition to a velvety appearance of palmar surfaces and ridging of the skin."
It's a condition called "tripe palms", named after the resemblance to tripe - the rippled stomach lining of cows, pigs and sheep.
The doctors added: "This condition, known as tripe palms, is closely associated with cancer, particularly lung and gastric cancer."
Tests
So, they decided to carry out a CT scan on the unnamed woman - who admitted being a heavy smoker with a persistent cough.
The results revealed abnormalities in her lungs and a subsequent biopsy confirmed she had a type of cancer known as adenocarcinoma.
She underwent chemotherapy and radiotherapy, but sadly her cancer worsened six months after she was first seen by medics.
A second round of chemotherapy was given, but doctors didn't reveal the outcome in their case report.
As for tripe palms, there is no specific treatment, however symptoms can resolve with cancer treatment.
But in this case they said it was unable to help.
The doctors wrote: "Tripe palm lesions may resolve with treatment of the underlying cancer.
"However, the lesions in this patient did not regress with chemotherapy or with the application of 10 percent urea-containing ointment."
What are tripe palms?
Tripe palms is a rare skin condition.
It's characterised by the surface of the skin on the hands becoming thickened and resembling the stomach lining of cows, sheep or pigs - known as tripe.
Around 95 per cent of cases are associated with cancer and tripe palms usually occurs before a diganosis is made.
The cause isn't clearly understood but it's thought that the associated cancer can stimulate palmar skin cells to proliferate.
There is no specific treatment but around 30 per cent of cases are resolved once the underlying cancer is treated.
Source: Dermnet NZ
Doctors stress that it is very rare, but rashes can be a tell-tale sign for cancer.
Potentially cancerous rashes can be all the more dangerous as they disguise themselves as more common, harmless skin problems.
Often a red rash that could be cancer looks very similar to those caused by psoriasis or eczema, experts warned.
They can cause red patches, itching, burning and dry, scaly skin, while raised blueish or yellow bumps may also appear.
This type of rash will last longer than other skin conditions and will likely grow in size or change as the cancer progresses.
And another tell-tale sign is it won't disappear when you use topical treatments like creams, often prescribed for a rash.
'Window to body'
Dr Walayat Hussain, a spokesman for the British Association of Dermatologists, said rashes can be a sign of cancer but stressed that most rashes are nothing to be concerned about.
He said: "The skin is like the window to the body if you like, so sometimes that can be a sign that something is going on inside the body.
"If you get a blistering rash affecting the inside of your mouth as well as your hands and feet - and it’s quite severe - then sometimes that can be a sign of what we call a paraneoplastic rash.
The skin is like the window to the body if you like, so sometimes that can be a sign that something is going on inside the body
Dr Walayat Hussain
"Paraneoplastic basically means it is associated with some form of cancer elsewhere in the body. If you treat the cancer, the rash goes away.
"The most common type of cancer that causes rashes and presents with symptoms that dermatologists are used to seeing are blood cancers.
"People who have leukaemia or lymphoma often present with specific things on the skin that dermatologists are trained to recognise."
Here's some of the rashes that could be a sign of cancer...
1. A patchy red rash that can turn scaly
Mycosis fungoides is a common rash in patients diagnosed with lymphoma.
Lymphoma is a cancer of the lymphatic system - the network of tissues and organs in our body that work to rid us of toxins.
It can be particularly dangerous because the cancerous cells can travel through the body in the bloodstream.
The cancer cells can then grow in several places at once, affecting multiple parts of the body.
A person with lymphoma may develop mycosis fungoides, a rash that is caused when the blood travels to the upper layer of the skin.
In its early stages it may appear as a patchy red rash but as it progresses it tends to become scaly.
It may be itchy and look similar to eczema.
2. Tiny red spots covering the skin
Leukaemia, a type of blood cancer that starts in the bone marrow, can spread throughout the body in the bloodstream.
A person with leukaemia may also develop tiny red spots on their skin known as petechiae.
The rash is caused by broken blood vessels under the skin.
Children may also develop a rash called acute myelogenous leukaemia, which causes dark spots to appear on the skin.
3. Reddish rash on your hands or back
Dermatomyositis tends to appear as changes around your nail folds, a reddish rash on the back of your hands, especially around the knuckles, and a shawl-like red rash on your back.
This rash can be associated with any type of cancer.
It can also appear on your face, eyelids, chest, knees and elbows.
Dermatomyositis can also cause muscle weakness and inflamed muscles.
4. Dark, thicker patches of skin
Acanthosis nigricans is when darker, thickened patches of skin develop around the armpit, groin and neck.
It's not a condition in itself but a sign of an underlying health problem.
The patches will be dry and rough, feeling similar to velvet, and can also be itchy.
Acanthosis nigricans usually develops slowly over time but spreading quickly has be linked to cancer.
BUT... in most cases a rash is NOT cancer
Dr Hussain said while a rash can be a warning sign of cancer it's not known why some people get a rash when they have the disease.
He explained that in some cases it could be that the abnormal cells are infiltrating the skin itself.
"All it is is just a clue or a sign that something is going on," he added.
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"Whether it is a specific skin response to the type of cancer, no one really knows.
"But the most common cause of a rash will NOT be cancer related. I think that is a really important message to give to people.
"The bottom line is if there is anything on your skin that you are worried about,you go and see your GP."