BACKGROUND: Bazex syndrome (acrokeratosis paraneoplastica) is a rare 
paraneoplastic syndrome that usually occurs in males over 40 years old and is 
particularly associated with squamous cell carcinoma of the upper aerodigestive 
tract and adenopathy above the diaphragm.
OBJECTIVE: The objectives of our article are (1) to describe a unique case of 
acrokeratosis paraneoplastica and (2) to review the current literature regarding 
skin findings, commonly associated neoplasms, and treatment options relative to 
this condition.
PATIENT: We describe a 68-year-old female with lobular breast carcinoma, 
complicated by local and distant recurrences, who presented with a 1-year 
history of prominent acral skin and nail changes.
RESULTS: Our patient's clinical skin findings improved significantly following 
treatment and partial remission of her underlying malignancy.
CONCLUSIONS: Our patient represents one of few females described with this 
syndrome, which is especially rare in association with lobular breast carcinoma. 
Further, the patient's presentation is unique as she was discovered to 
demonstrate laboratory findings consistent with coexistent porphyria cutanea 
tarda and relative zinc deficiency.