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A paraneoplastic syndrome characterized by the sudden appearance of multiple seborrheic keratoses or rapid increase in the number and size of pre-existing seborrheic keratoses, with or without associated pruritus.
Leser-Trélat sign refers to the sudden eruption of multiple seborrheic keratoses caused by a malignancy.
Most commonly associated with adenocarcinomas of the GI tract, but also breast, ovary, lung, uterus, kidney, liver,melanoma and pancreas.
Often associated with malignant acanthosis nigricans, a sign of internal cancer.
May be seen with squamous cell cancers, lymphomas and leukemias.
Possibly related to endogenous production of mediators such as epidermal growth factor, transforming growth factor-alpha.
May be seen with HIV, pregnancy and following heart transplantation.
Appearance suggests investigation for underlying malignancy.
Validity of its relationship to cancer is questionable.
Associated malignancy is usually aggressive, with a poor prognosis.
Treating underlying malignancy results in approximately 50% of patient’s experiencing resolution of seborrheic keratoses.
Multiple seborrheic keratoses of TL sign are benign.
While only malignant neoplasms meet the definition of the sign of Leser-Trélat, it has been described in benign adenomatous neoplasms.