The Sign of Leser-Trélat in Association With Sézary Syndrome: Simultaneous Disappearance of Seborrheic Keratoses and Malignant T-Cell Clone During Combined Therapy With Photopheresis and Interferon Alfa

Abstract

Among the clinical entities felt to result from biologically active agents produced by neoplasms is the proliferative skin disorder of Leser-Trelat. This syndrome is characterized by the rapid emergence of multiple seborrheic keratoses in association with an internal malignancy. Though traditionally associated with adenocarcinomas of the stomach, hematopoietic malignancies are the second most recorded neoplasm to be linked with the sign of Leser-Trelat. 1 Moreover, there have been several specific cases in patients with mycosis fungoides and Sezary syndrome. 2-4 In this report, we document an additional case of multiple seborrheic keratoses paralleling the evolution of Sezary syndrome and its response to a new combination treatment with interferon alfa and extracorporeal photopheresis. 5 Our observation of the resolution of the sign of Leser-Trelat in concert with the induction of a complete remission of the cutaneous T-cell lymphoma, which is documented at the clinical and molecular level, is discussed. Report of