Leser–Trélat sign

Leser–Trélat sign is a medical condition characterized by the sudden appearance and rapid increase in size and number of seborrheic keratoses. This condition is often associated with underlying malignancies, particularly adenocarcinomas. The sign is named after the French physicians Edmund Leser and Ulysse Trélat, who first described the association in the late 19th century.

History

The Leser–Trélat sign was first described by Edmund Leser and Ulysse Trélat in the late 19th century. They observed a sudden eruption of multiple seborrheic keratoses in patients with internal malignancies. This observation led to the hypothesis that the sudden appearance of these skin lesions could be a sign of an underlying malignancy.

Clinical Presentation

Patients with Leser–Trélat sign typically present with a sudden eruption of multiple seborrheic keratoses. These skin lesions are usually dark, wart-like growths that appear predominantly on the trunk. They may vary in size and number, and can increase rapidly over a short period of time. In addition to the skin lesions, patients may also present with symptoms related to the underlying malignancy, such as unexplained weight loss, fatigue, and abdominal pain.

Pathophysiology

The exact mechanism of Leser–Trélat sign is not fully understood. It is believed that the underlying malignancy produces certain growth factors that stimulate the proliferation of keratinocytes, leading to the formation of seborrheic keratoses. The most commonly associated malignancies are adenocarcinomas, particularly of the gastrointestinal tract.

Diagnosis

The diagnosis of Leser–Trélat sign is primarily clinical, based on the sudden appearance and rapid increase in size and number of seborrheic keratoses. A thorough investigation is required to identify the underlying malignancy. This may include blood tests, imaging studies, and tissue biopsy.

Treatment

The treatment of Leser–Trélat sign involves addressing the underlying malignancy. The seborrheic keratoses themselves do not require treatment unless they become symptomatic or cosmetically unacceptable. In such cases, they can be removed by various methods such as cryotherapy, curettage, or laser therapy.

Prognosis

The prognosis of Leser–Trélat sign is largely dependent on the underlying malignancy. Early detection and treatment of the malignancy can improve the prognosis.

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  Seborrheic keratosis on human back