BACKGROUND: Acrokeratosis paraneoplastica Bazex (APB) is a very rare disease in 
the group of obligate paraneoplastic dermatoses, associated mostly with squamous 
cell carcinoma of the upper aerodigestive tract and metastatic cervical 
lymphadenopathy. The disease is characterized by violaceous erythemosquamous 
changes on the acral regions. This entity was first reported by Bazex in 1965. 
About 160 cases have been presented so far.
CASE REPORT: We presented a patient with a three-month history of violaceous 
erythema, edema, erosions and scaling on the acral regions, elbows and knees and 
severe nail dystrophy. When the diagnosis was established, he did not have any 
symptom of internal malignancy. Esophagogastroscopy revealed ulcerovegetant 
lesion of the esophagus, while histology showed squamocellular invasive 
carcinoma. Surgical tumor removal resulted in significant improvement of skin 
changes in 15 days. Unfortunately, four months later, extensive skin lesions 
pointed to metastasis of squamous cell carcinoma.
CONCLUSION: Skin changes can precede a few years the first manifestations of 
neoplasia. The course of the disease in our patient proved that APB is a 
specific marker of underlying malignancy.