Acanthosis nigricans and "tripe palm" as paraneoplastic manifestations of metastatic tumor

acanthosis nigricans is a common dermatosis and is most often associated with benign conditions, such as insulin resistance. it is rare as a paraneoplastic marker. as such, it is characterized by sudden onset and rapid dissemination of velvety and hyperchromic skin lesions. the term "tripe palm" refers to exaggeration of the palmar ridge pattern, which resembles the internal surface of the bovine intestinal tract. this is a paraneoplastic marker of high specificity, with 90% of the cases being associated with malignancy. we report the case of a patient with stage iv ovarian adenocarcinoma presenting acanthosis nigricans and tripe palm. both findings are closely correlated to the neoplasm course.