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March 2005

Acral Psoriasiform Eruption in a Man With a Squamous Cell Carcinoma of the Tonsillar Pillar—Diagnosis

Arch Dermatol. 2005;141(3):389-394. doi:10.1001/archderm.141.3.390-b

Routine hematoxylin-eosin staining of the biopsy specimen revealed hyperkeratosis, focal parakeratosis, and psoriasiform hyperplasia with spongiosis and focal microvesiculation as well as a superficial to middermal perivascular lymphocytic infiltrate.

Based on the clinical and microscopic findings, a diagnosis of AP was made. Chemotherapy and radiation therapy resulted in only partial improvement, although at the time of the patient’s referral, his disease was thought to be in remission. Further evaluation was suggested. Approximately 2 months after diagnosis, he developed hip pain and was found to have advanced disease, with lytic metastatic involvement of the left ischium. He died within 6 weeks after the metastases were detected.

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