Malignant Acanthosis Nigricans with Enhanced Expression of Fibroblast Growth Factor Receptor 3

Abstract

Letters to the Editor 435 since 1990 have reported the use of terlipressin for the treatment of HRS with good outcomes and low risk of adverse effects. Incidence of secondary ischaemic events in HRS differs depending on series from 5% to 29% (1. 2, 8, 9). Significantly, a recent meta-analysis revealed that no permanent interruption of terlipressin was needed because of intolerance ( I ).Undesirable effects are usually mild and disappear by lowering the dose of the drug. i.e. paleness, acral cyanosis, abdominal pain, diarrhoea, headache and self-limiting cardiac arrhythmias. However, serious ischaemic events, such as skin necrosis involving the extremities, scrotum, penis or abdominal skin have been documented (1-3, 5, 6. 8. 9). Obesity, venous insufficiency and spontaneous bacterial peritonitis have been proposed as possible risk factors for the development of ischaemic cutaneous complications (3, 5).Our patient did not have a medical history of ischaemic disease and, at physical examination, he was not obese and showed no signs of venous insufficiency. Repeated negative ascitic cultures ruled out a spontaneous bacterial peritonitis. The doses of terlipressin administered were low. This case is of clinical importance due to the large area of cutaneous necrosis and its rapid occurrence, without resolution after terlipressin withdrawal.In conclusion, we report here a new case of cutaneous necrosis secondary to terlipressin therapy for management of HRS. Although rare, we must bear in mind the possibility of ischaemic complication of terlipresshi.

Malignant Acanthosis Nigricans, Florid Cutaneous Papillomatosis and Tripe Palms Syndrome Associated with Gastric Adenocarcinoma - a Case Report

“…TGF-alpha is a primary mediator of benign and malignant keratinocyte hyperproliferation in vivo (58). Some authors speculate that activation of fi broblast growth factor receptor 3 (FGFR3) might have some relevance to the formation of MAN (59). Simultaneous activation of epidermal growth factor receptor 3 (EGFR3), insulin-like growth factor--1 (IGF-1) and melanocyte stimulating hormone  ; a systemic immunologic response to the primary tumor as a cause cannot be discarded (13).…”

Acanthosis Nigricans Associated with an Adrenocortical Tumor in a Pediatric Patient

“…Hereditary diseases associated with AN demonstrate activating germ line mutations in the fibroblast growth factor receptor 3 (FGFR3) gene, which increase keratinocyte growth [18–21]. A positive association of FGFR3 expression has been reported in two cases of malignant AN, with expression throughout the acanthotic lesions [22]. …”

Papilomatose cutânea florida e acantose nigricante maligna reveladoras de neoplasia gástrica

“…Hida et al also reported the possible role of fibroblast growth factor receptor 3 (FGFR3) in the etiopathogenesis of ANM. 16 The case reported here, with typical lesions of acanthosis nigricans maligna, florid cutaneous papillomatosis and tripe palms occurred in the absence of any gastrointestinal complaint. Since gastric adenocarcinoma is the most common neoplasia associated with these paraneoplastic dermatoses, supplementary diagnostic tests were performed and a malignant gastric tumor was confirmed, already with distant lung metastases and regional lymph node metastasis.…”