Leser-Trelat sign


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.


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