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To the Editor:—
In the September issue of the Archives of Dermatology and Syphilology (44:349, 1941) Leslie Nicholas, describing an interesting case of acanthosis nigricans, stated: "In no instance heretofore, however, has it [acanthosis nigricans] been described in association with and immediately overlying deep metastatic malignant growths of the skin."There is, however, a case reported by W. Dubreuilh (Ann. de dermat. et syph.7:67, 1918) in which metastases of a cancer of the stomach were found in the skin underlying acanthosis nigricans. This is the case of a 22 year old French soldier, who died about four months after onset of severe gastric symptoms and eight months after acanthosis nigricans made its first appearance. At autopsy generalized acanthosis nigricans, ulcerated carcinoma of the pyloric region and metastases in the deep skin or on the border of the hypoderm, in many lymph glands and in the lymph vessels