Leser-Trelat sign

The Leser-Trélat sign is the explosive onset of multiple pruritic seborrheic keratoses, often with an inflammatory base. This can be an ominous sign of internal malignancy as part of a paraneoplastic syndrome. In addition to the development of new lesions, preexisting ones frequently increase in size and become symptomatic.

Although most associated neoplasms are gastrointestinal adenocarcinomas (stomach, liver, colorectal and pancreas), breast, lung, and urinary tract cancers, as well as lymphoid malignancies are associated with this impressive rash. It is likely that various cytokines and other growth factors produced by the neoplasm are responsible for the abrupt appearance of the seborrheic keratoses. In some cases, paraneoplastic acanthosis nigricans accompanies the sign of Leser-Trelat.

References

• Heaphy, MR Jr, Millns, JL, Schroeter, AL. The sign of Leser-Trelat in a case of adenocarcinoma of the lung. J Am Acad Dermatol 2000; 43:386.

• Kurzrock, R, Cohen, PR. Cutaneous paraneoplastic syndromes in solid tumors. Am J Med 1995; 99:662.

• Schwartz, RA. Sign of Leser-Trelat. J Am Acad Dermatol 1996; 35:88.

• Gregory, B, Ho, VC. Cutaneous manifestations of gastrointestinal disorders. Part I. J Am Acad Dermatol 1992; 26:153.

• Kilickap S, Yalcin B. The Sign of Leser-Trelat. N Engl J Med. 2007; 356:2184.

• Yaniv R, Servadio Y, Feinstein A, Trau H. The sign of Leser-Trelat associated with transitional cell carcinoma of the urinary-bladder--a case report and short review. Clin Exp Dermatol. 1994; 19(2):142.