Leser–Trélat syndrome: What does it hide?

Abstract

Sir, Seborrheic keratoses (SKs) are common, benign, non-melanocytic epidermal tumors [1]. Still, they may be suspicious of other, more serious underlying conditions. Leser–Trélat syndrome may be considered a paraneoplastic condition characterized by the sudden onset of multiple SKs [2]. Herein, we report two cases of malignancy revealed by eruptive KS. The first case, an 83-year-old male with no notable pathological history, presented for two years with rapidly evolving lesions of the trunk over a six-month period. The patient also noticed for three months melena with transit disorders, justifying a consultation in which the diagnosis of sigmoid tumor was reached and the patient was referred for surgery. A clinical examination revealed multiple, sessile, exophytic tumors of round or oval appearance, 1 to 3 cm in diameter, well-delimited. The surface of the lesions was verrucous, brownish-black, with numerous, black, keratotic plugs (Fig. 1a). A dermoscopic examination revealed a cerebral appearance with pseudocysts and pseudocomedones (Fig. 1b). The diagnosis of seborrheic keratosis was thus reached.