A Woman's 'Velvety' Palms Revealed Her Lung Cancer

The woman’s hand, next to a CT image of her lungs. (Image: Denis Miyashiro, M.D., and Jose A. Sanches, New England Journal of Medicine)

A Brazilian woman’s strangely textured palms led to the discovery of a much more serious underlying health problem: lung cancer.

According to a case report published this week in the New England Journal of Medicine, the 73-year-old woman had visited a local dermatology clinic with complaints of itchy and painful lesions on the palms of both hands. The symptoms had first shown up nine months earlier. When doctors took a closer look at her palms, they noticed especially sharp lines in the natural folds of her hands, along with additional ridged lines and an overall “velvety appearance” to both palms.

In medical terms, the woman had a rare condition sometimes called palmoplantar keratoderma or acanthosis nigricans. But in the 1970s, a doctor coined a more memorable name for it, after realising that her patient’s skin looked just like a food made from the stomachs of cows and sheep: tripe palm.

Unfortunately, the appearance of tripe palm is almost always linked to certain cancers, typically the gastric or lung variety. Adding to that, the woman had smoked the equivalent of a pack a day for 30 years, and she had also been dealing with a nagging cough and weight loss. Unsurprisingly, a CAT scan revealed she had lung cancer.

Tripe palm is a rare occurrence, even among people with cancer. And it’s still unclear exactly why it happens, though some researchers think cancer can somehow stimulate the overproduction of skin cells on the palm.

While it can go away if a person’s cancer is treated, that didn’t happen in this case, nor did an ointment treatment seem to help. And despite going on both chemotherapy and radiation, the woman’s cancer continued to progress by the six month mark of her treatment course. At the time of publication, the authors wrote that she had began another treatment, but gave no other updates on her condition.

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