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To the Editor.—
The sign of Leser-Trélat is defined as the sudden appearance and rapid increase in number of seborrheic keratoses on a skin that was blemish free and is taken to indicate an internal malignant tumor. In a past issue of the Archives, Dantzig (108:700, 1973) reported a case with multiple warty papules appearing on the back, shoulders, and chest of a patient with an erythroderma that was shown to be a Sezary syndrome. The author suggests that this is a representation of the sign of Leser-Trélat. After reviewing many of the published cases and standard texts, I cannot but feel that the rapid appearance of seborrheic keratoses on skin that is otherwise normal is implied in and important to the definition of this sign. I suggest that what Dr. Dantzig is reporting is the appearance of warty papillomas in areas of severe dermatitis. This has been observed by
Brown FC. Sign of Leser-Trélat. Arch Dermatol. 1974;110(1):129. doi:10.1001/archderm.1974.01630070087025