a, Malignant acanthosis nigricans affecting the vermilion and commissures of the lips. A gastric carcinoma was discovered following the development of florid cutaneous and mucosal papillomatosis (Courtesy of Dr. Hagen B. E. Klieb, DOI: 10.1200/JCO.2012.45.2151). b, Same patient as a. Note: the florid papillomatous lesions on the hard palate, alveolar ridge and upper labial mucosa. This patient’s case history was published in reference. (from Non-HPV Papillary Lesions of the Oral Mucosa: Clinical and Histopathologic Features of Reactive and Neoplastic Conditions)
The sudden onset of florid papillomatosis of the lips, labial commissures or oral mucosa is characteristic of acanthosis nigricans, a paraneoplastic condition associated with gastrointestinal malignancy.