An Unusual Progression of Bazex Syndrome (Acrokeratosis Paraneoplastica)

Acrokeratosis paraneoplastica, also known as Bazex syndrome, is a rare paraneoplastic psoriasiform dermatosis that is strongly associated with squamous cell carcinoma (SCC) of mainly the head and neck. The disease typically progresses through three stages, initially affecting the fingernails, nose, and ears before spreading to the palms, soles, and eventually the trunk. We present an unusual progression of a psoriasiform rash in which the dorsal hands, trunk, and legs were primarily affected before involving the palmar hands and ears in a patient later diagnosed with oral SCC. This case also highlights the importance of maintaining a high index of suspicion for paraneoplastic conditions that could lead to more prompt diagnoses of internal malignancies and improve patient outcomes.