Palmar fasciitis and polyarthritis syndrome (PFPAS) is a paraneoplastic syndrome that is classically seen with ovarian carcinoma but which can occur with a variety of other malignancies.
Clinical elements:
(1) palmar fasciitis
(2) polyarthritis
The palmar fasciitis is associated with:
(1) induration and fibrosis of the palms, described as "woody"
(2) a positive "groove" sign
(3) flexion contractures of the fingers
(4) palmar erythema with swelling
The arthritis tends to affect peripheral joints of the extremities:
(1) fingers
(2) shoulders
(3) elbows
(4) wrists
(5) knees
(6) ankles
(7) feet
Tumors associated with PFPAS:
(1) ovarian carcinoma
(2) protate carcinoma
(3) lung carcinoma
(4) breast carcinoma
(5) pancreatic carcinoma
(6) malignant lymphoma
The onset of symptoms of PFPAS may precede diagnosis of the occult malignancy by months or even years.
Differential diagnosis:
(1) palmar fibromatosis (Dupuytren's)
(2) rheumatoid arthritis
(3) scleroderma
(4) eosinophilic fasciitis
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