WOODY HANDS IN A PATIENT WITH PANCREATIC-CARCINOMA - A VARIANT OF CANCER-ASSOCIATED FASCIITIS-PANNICULITIS SYNDROME

We report an elderly woman with rapidly progressive painless, woody in duration of the hands. Mild diabetes mellitus was demonstrated, Skin b iopsy features included broad fibrous bands extending deeply into subc utaneous fat, a mild mononuclear cell infiltrate, and post-thrombotic recanalization of a deep vessel in one specimen, The patient developed uncontrolled haematemesis and was demonstrated at laparotomy to have disseminated pancreatic carcinoma, The unusual clinical features and t emporal relationship between the skin changes and the tumour suggest a paraneoplastic eruption, which appears best classified as an example of cancer-associated fasciitis-panniculitis syndrome.