The Leser-Trélat sign is characterized by the sudden appearance and rapid increase in both the size and number of seborrheic keratoses. This paraneoplastic syndrome is most frequently associated with adenocarcinoma (67%), with the gastrointestinal (GI) tract being the most common primary tumor site (72%). However, in 22% of cases, the syndrome has been associated with lymphoproliferative malignant neoplasms. We describe herein a patient with the Leser-Trélat sign who had a lymphocytic lymphoma and later was found to have an adenocarcinoma of the large bowel.
Report of a Case
An obese, 59-year-old woman had a recent history of easy fatigability and malaise. Two months before, she had noticed the sudden appearance of many "warts" on her face and neck. On physical examination, multiple, 2- to 6-mm, seborrheic keratoses and numerous pigmented filariform papillomas were present on the neck and malar regions (Figure). Examination of the abdomen disclosed moderate hepatosplenomegaly. Findings from
Wagner RF, Wagner KD. Malignant Neoplasms and the Leser-Trélat Sign. Arch Dermatol. 1981;117(9):598-599. doi:10.1001/archderm.1981.01650090080036