A 55-year-old white man born in Canada presented with all the clinical features 
of acrokeratosis paraneoplastica of Bazex. He showed the characteristic 
violaceous erythema and scaling of the nose and face, the aural helices, and the 
palmoplantar regions with severe nail dystrophy. Extensive examinations failed 
to reveal any associated malignancy up to 5 months after the onset of the skin 
eruption. While the skin was improving, and although the patient was still 
asymptomatic except for a weight loss of 5 kg, evidence of metastatic squamous 
cell carcinoma of the cervical region was obtained. Only palliative treatment 
could be undertaken. The bizarre clinical aspects of the syndrome are reviewed.