OPHTHALMIC MANIFESTATIONS OF ACANTHOSIS NIGRICANS

A 77-year-old man had fleshy papillomatous lesions on his eyelid margi ns, which initially were accompanied by lesions on his lips and tongue and plaques on his scrotum, areolae, neck, axillae, and hands. He had had adenocarcinoma of the sigmoid colon and stomach. Based on the cli nical findings and histopathologic evaluation of the eyelids (showing papillomatous changes with hyperkeratosis and mild acanthosis), the di agnosis of acanthosis nigricans was made. Acanthosis nigricans may be benign or malignant; in this patient it was malignant. The malignant f orm is usually of gastrointestinal origin, and in adults may be a mark er for an occult malignancy.