Introduction Paraneoplastic papuloerythroderma Ofuji (PEO) is a rare exfoliative erythroderma characterized by severe pruritus with diffuse erythema and scaling with relative sparing of the skin folds.1 It is often associated with an underlying malignancy. Recognition can be particularly challenging in patients with pre-existing inflammatory dermatoses, as new paraneoplastic erythroderma may be misattributed to progression or treatment failure of the underlying condition.