How a 73-year-old heavy smoker's 'velvety' palms turned out to be a sign of lung cancer


How a 73-year-old heavy smoker’s ‘velvety’ palms that looked like TRIPE turned out to be a sign of lung cancer

  • The unnamed woman also had a cough for a year and had lost 11lbs (5kg)
  • Velvety palms are called ‘tripe palms’ and often signal an underlying cancer
  • Tests revealed the woman had adenocarcinoma and she had treatment 

A woman’s velvety palms which looked like tripe turned out to be a rare sign of lung cancer, doctors have revealed.

The 73-year-old, of São Paulo, Brazil, visited a dermatology clinic complaining about the painful and itchy lesions on her hands.  

She was diagnosed with ‘tripe palms’, named because of the resemblance to tripe – the rippled stomach lining of cows, pigs, and sheep. 

Although rare, doctors who treated her recognised the most common cause of the unusual condition is underlying cancer.

And tests revealed the unidentified woman – a heavy smoker who had a persistent cough – did in fact have adenocarcinoma, a type of lung cancer.

She went through treatment but it is unclear if she recovered from the cancer, or if her palms ever went back to normal.

A 73-year-old woman's velvety 'tripe palms' (pictured) turned out to be a sign of lung cancer

A 73-year-old woman’s velvety ‘tripe palms’ (pictured) turned out to be a sign of lung cancer 

The woman was given a CT scan for her chest (pictured), abdomen and pelvis, which revealed abnormalities in her lungs. The left upper lobe of her lung showed abnormalities

The woman was given a CT scan for her chest (pictured), abdomen and pelvis, which revealed abnormalities in her lungs. The left upper lobe of her lung showed abnormalities 

The condition is called tripe palms because of the resemblance to tripe - the rippled stomach lining of cows (pictured), pigs, and sheep

The condition is called tripe palms because of the resemblance to tripe – the rippled stomach lining of cows (pictured), pigs, and sheep

Dr Denis Miyashiro and colleagues at Universidade de São Paulo told the case in The New England Journal of Medicine, Science Alert reports.

They described how the woman also had suffered a cough for about a year and had lost 11lbs (5kg) in the last four months alone. 

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The elderly woman was a heavy smoker, going through a pack of cigarettes every day for 30 years. 

She first noticed her palms had a velvety appearance nine months before she went to see a dermatologist.

The doctors wrote in the journal: ‘Physical examination revealed sharp demarcation of the folds in the lines of her hands in addition to a velvety appearance of palmar surfaces and ridging of the skin.’ 

WHAT ARE TRIPE PALMS? 

Tripe palms, also known as acanthosis palmaris and acquired pachydermatoglyphi, have the appearance of tripe – the stomach lining of beef, pork, or sheep. 

Approximately 95 per cent cases of tripe palms are associated with cancer, Italian doctors wrote in Dermatology Online Journal in 2012.

This skin disease is very rare. It usually occurs before the diagnosis of the cancer.

Although it is not clear why tripe palms occur, it is suggested that secretions of the cancer stimulate growth hormones that cause skin cells in the palm to proliferate.

There is no specific treatment. Around 30 per cent of cases resolve once the underlying cancer is treated. However, it may persist for many years despite remission of the underlying cancer.

Tripe palms is also known as acanthosis palmaris or acquired pachydermatoglyphia. 

It is a sign of cancer – most commonly lung or stomach – in 95 per cent of cases, statistics show.

Why tripe palms occurs is not clearly understood. One theory is that secretions of the cancer stimulate growth hormones that cause skin cells in the palm to multiply. 

The woman was given a CT scan for her chest, abdomen and pelvis, which revealed abnormalities in her lungs.

She had irregular nodules in the top part of her left lung and enlarged lymph nodes in the chest area – a common symptom of cancer.  

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A biopsy was taken which confirmed she had adenocarcinoma – cancer that forms in mucus-secreting glands. 

The disease may develop in many different places but it is most prevalent in the lungs, accounting for most cases of non-small cell lung cancer.

The woman underwent chemotherapy and radiation therapy, but sadly her cancer worsened six months after she was first seen by medics.

She began a second round of chemotherapy but the doctors did not reveal what her outcome was in their case report.

The survival rate for lung cancer depends heavily on the stage at diagnosis – with survival odds much lower for aggressive forms. 

Lung Health UK says approximately 15 per cent of patients will survive for five years after being diagnosed with adenocarcinoma.

As for tripe palms, there is no specific treatment. Estimates suggest around a third of cases resolve with cancer therapy. 

The doctors wrote: ‘Tripe palm lesions may resolve with treatment of the underlying cancer.

‘However, the lesions in this patient did not regress with chemotherapy or with the application of 10 percent urea-containing ointment.’

WHAT IS LUNG CANCER? 

Lung cancer is one of the most common and serious types of cancer. 

Around 47,000 people are diagnosed with the condition every year in the UK.

There are usually no signs or symptoms in the early stages of lung cancer, but many people with the condition eventually develop symptoms including:

– a persistent cough

– coughing up blood

– persistent breathlessness

– unexplained tiredness and weight loss

– an ache or pain when breathing or coughing

You should see a GP if you have these symptoms.

Types of lung cancer 

There are two main forms of primary lung cancer. 

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These are classified by the type of cells in which the cancer starts growing. 

They are:

– Non-small-cell lung cancer. The most common form, accounting for more than 87 per cent of cases. 

– It can be one of three types: squamous cell carcinoma, adenocarcinoma or large-cell carcinoma.

– Small-cell lung cancer – a less common form that usually spreads faster than non-small-cell lung cancer.

– The type of lung cancer you have determines which treatments are recommended.

Who’s affected

Lung cancer mainly affects older people. It’s rare in people younger than 40. 

More than four out of 10 people diagnosed with lung cancer in the UK are aged 75 and older.

Although people who have never smoked can develop lung cancer, smoking is the most common cause (accounting for about 72 per cent of cases). 

This is because smoking involves regularly inhaling a number of different toxic substances.

Treating lung cancer

Treatment depends on the type of mutation the cancer has, how far it’s spread and how good your general health is.

If the condition is diagnosed early and the cancerous cells are confined to a small area, surgery to remove the affected area of lung may be recommended.

If surgery is unsuitable due to your general health, radiotherapy to destroy the cancerous cells may be recommended instead.

If the cancer has spread too far for surgery or radiotherapy to be effective, chemotherapy is usually used.

There are also a number of medicines known as targeted therapies. 

They target a specific change in or around the cancer cells that is helping them to grow. 

Targeted therapies cannot cure lung cancer but they can slow its spread.

Source: NHS 

 



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