Acanthosis nigricans is a skin disease characterised by symmetric velvety hyperpigmented, verrucous plaques of the intertriginous surfaces of the axilla, neck, inframammary, and mucocutaneous regions. Malignant acanthosis nigricans is a paraneoplastic phenomenon most commonly associated with gastric adenocarcinoma. Tripe palms, florid cutaneous papillomatosis and oral involvement along with generalised acanthosis nigricans are the features which are highly suggestive of internal malignancy. This case report describes a rare case of a patient who presented with combination of malignant acanthosis nigricans, tripe palms, florid cutaneous papillomatosis and oral involvement associated with undifferentiated malignant neoplasm of hepatic bile ducts.