PMC4718246_01
(A) Dark red, infiltrative, desquamative plaques on the nose and cheeks; (B) Dark red, infiltrative plaques with scales on the right auricle; (C) confluent erythema covered with yellow thick crust on the knees; (D) infiltrative erythematous plaques with scales on the dorsa of interphalangeal joints; all the fingernails were yellow-brown and thickened, with subungual keratotic debris; and (E) both plantar pedis were discolored and hyperkeratotic.
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F1
On physical examination, infiltrative erythematous plaques with scales were observed on the nose, cheeks, ears, and the dorsa of interphalangeal joints (Figure 1A, B); confluent erythema covered with yellow thick crust were seen on the knees (Figure 1C); all the fingernails were yellow-brown and thickened, with subungual keratotic debris (Figure 1D); both plantar pedis were discolored and hyperkeratotic (Figure 1E).
(A) Computed tomography of the chest showed pulmonary adenocarcinoma on the right lower lobe with multiple local metastatic nodules; the mediastinal lymph nodes were swollen; (B) the histological examination of cutaneous lesions on the left knee (HE x200) exhibited pronounced epidermal hyperkeratosis and parakeratosis, mild irregular acanthosis, mononuclear cell infiltration around blood vessels within the upper dermis, and roughly normal subcutaneous tissue.
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F2
The computed tomography (CT) scan detected a pulmonary adenocarcinoma and a number of local metastatic nodules on the right lower lobe, along with mediastinal swollen lymph nodes (Figure 2A). We performed a biopsy of cutaneous lesion over the left knee, which exhibited pronounced epidermal hyperkeratosis and parakeratosis, mild irregular acanthosis, mononuclear cell infiltration around blood vessels within the upper dermis, and roughly normal subcutaneous tissue (Figure 2B).
(A, B) After treatment with Gefitinib, the facial lesions alleviated significantly.
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F3
Notably, his cutaneous lesions alleviated significantly (Figure 3A, B).