Acrokeratosis paraneoplastica (Bazex' syndrome) is a rare but clinically 
distinctive dermatosis that has been associated in all reported cases, to our 
knowledge, with either a primary malignant neoplasm of the upper aerodigestive 
tract or metastatic cancer to the lymph nodes of the neck. Acrokeratosis 
paraneoplastica was found in a 53-year-old black man with squamous cell 
carcinoma of the tonsil. A distinctive series of changes was found on 
histopathologic examination of biopsy specimens taken from his skin lesions, and 
direct immunofluorescence microscopy of both lesional and nonlesional skin 
specimens showed immunoglobulin and complement deposition on the epidermal 
basement membrane. The skin lesions largely resolved following radiation therapy 
of the neoplasm and of the presumably involved lymph nodes.