Multiple Seborrheic Keratoses Research Articles

Malignant acanthosis nigricans, tripe palms and the sign of Leser-Tre'lat, a hint to the diagnosis of early stage ovarian cancer: A case report and review of the literature

Background Malignant acanthosis nigricans is a mucocutaneous eruption associated with internal malignancies. Tripe palms refers to a characteristic velvety thickening of the palms, with exaggeration of normal skin markings. The sign of Leser-Tre'lat is the presence of multiple seborrheic keratoses and scattered skin tags caused by a malignancy. We are reporting the first case of ovarian cancer in association with three coexisting cutaneous paraneoplastic dermatosis. Case A 52-year-old female presented with skin manifestation consistent with MAN, TP and the sign of Leser-Tre'lat. Patient underwent extensive work up and was discovered to have stage I, high grade adenocarcinoma of the ovary. Skin manifestations gradually recovered after initiation of chemotherapy. Conclusion The presence of acanthosis nigricans in conjunction with tripe palms and the sign of Leser-Tre'lat are highly suggestive of an internal malignancy and necessitate an extensive investigation in order to discover the underlying malignancy.

Queratosis seborreicas en un paciente con micosis fungoide: respuesta a carmustina tópica

—Seborrheic keratoses are very common benign lesions, especially in elder people. They have been described in association with several dermatological disorders, including mycosis fungoides. We report a patient with mycosis fungoides and multiple seborrheic keratoses, specially over the plaques of mycosis fungoides. These seborrheic keratoses were infiltrated by atypical T lymphocytes and dissappeared several months after treatment with topical carmustine was started. We hipothesize that the antiproliferative activity of carmustine was responsible for the removal of the seborrheic keratoses.

Signo de Leser-Trélat asociado a síndrome de Sézary

Abstract—The profusion of seborrheic keratoses secondary to a neoplastic process is known as the sign of Leser-Trélat. Although the symptoms have typically been included within facultative paraneoplastic dermatoses, the validity of their paraneoplastic nature has been debated by some authors in recent decades. We present the case of an 82-year-old male in whom the abrupt appearance of multiple seborrheic keratoses made us suspect the possibility of an underlying neoplasm. Later studies led us to diagnose an associated Sézary syndrome. The simultaneous appearance of the dermatosis and the tumor, and the parallel evolutionary course that we observed between the two processes, are arguments in favor of the existence of the sign of Leser-Trélat and of its importance in clinical practice as a neoplasm marker.

Transient eruptive seborrheic keratoses associated with erythrodermic psoriasis and erythrodermic drug eruption: Report of two cases

The appearance of multiple seborrheic keratoses in association with underlying internal malignancy (known as the sign of Leser-Trelat) has generated much discussion and debate in the literature. However, comparatively few case reports exist that examine the appearance of multiple seborrheic keratoses associated with exfoliative erythroderma without underlying malignancy. We report 2 cases in which multiple, biopsy-proven seborrheic keratoses appeared in conjunction with erythrodermic skin eruptions. The underlying diseases in these 2 patients included psoriasis and an eczematous drug eruption; in both cases the erythroderma resolved with appropriate treatment. After resolution of the erythroderma, the newly developed seborrheic keratoses proceeded to involute and gradually fall off. Neither of the patients exhibited any evidence of internal malignancy. These cases represent the first reports of psoriasis and drug eruption as causes of erythroderma-induced transient eruptive seborrheic keratoses. Clinical and pathologic findings are consistent with previous descriptions of this entity. (J Am Acad Dermatol 2001;45:S212-4.)

経過中に白斑とＬｅｓｅｒ‐Ｔｒｅｌａｔ徴候が出現した皮膚悪性リンパ腫（ＣＴＣＬ）

We reported a case of cutaneous T cell lymphoma (CTCL) associated with multiple seborrheic keratosis and vitiligo. A reddish nodule appeared on the chest of a 63 years old Japanese male patient, and the noduler lesions continued to appear on his trunk, head and neck. Examinations including skin biopsy established the diagnosis of CTCL of non-mycosis fungoides type. Two years later, multiple seborrheic keratosis suddenly appeared on his trunk accompanied by severe itching. In addition, vitiligo-like depigmentation developed surrounding a lymphoma lesion in his left axilla. We concluded this case was unique CTCL showing Laser-Trélat sign and associated with vitiligo-like depigmentation.

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

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

The sign of Leser‐Trélat: fact or myth?

AbstractA 46‐year‐old woman presented with multiple seborrheic keratoses disseminated over her trunk and thighs. A screening for internal malignancies revealed an adenocarcinoma of the colon that was successfully treated by surgery. During a follow‐up period of 18 months, the seborrheic keratoses remained unchanged. There was no evidence of recurrence of the malignancy. We conclude that this case does not fulfill the criteria of the ‘sign of Leser‐Trélat’; according to present knowledge the existence of this cutaneous paraneoplastic syndrome cannot be taken as a certain indication. Patients with multiple seborrheic keratoses do not necessarily present internal malignancies.

Pemphigus erythematosus resembling multiple seborrheic keratoses

To the Editor.— Superficial pemphigus, whether of the erythematous or foliaceous kind, may simulate other dermatoses such as lupus erythematosus or seborrheic dermatitis. We describe a patient in whom pemphigus erythematosus presented clinically as multiple seborrheic keratoses. There are two recent reports on the clinical presentation of pemphigus foliaceous. 1,2 Report of a Case.— A 56-year-old black man had a 10-year history of intermittent treatment for superficial pemphigus. Over the last 2 years, as his bullous disease had become more benign, hyperpigmented, warty lesions gradually developed on his back and chest. He was in good health, and the abnormal physical findings were confined to the skin. Over the back and upper extremities, there were numerous well-defined, raised, hyperpigmented, hyperkeratotic lesions ranging in diameter from 1 to 3 cm. The lesions on the back tended to follow the lines of skin cleavage and had an elongated shape (Fig 1). Most lesions

Pemphigus Erythematosus Resembling Multiple Seborrheic Keratoses

To the Editor.— Superficial pemphigus, whether of the erythematous or foliaceous kind, may simulate other dermatoses such as lupus erythematosus or seborrheic dermatitis. We describe a patient in whom pemphigus erythematosus presented clinically as multiple seborrheic keratoses. There are two recent reports on the clinical presentation of pemphigus foliaceous. 1,2 Report of a Case.— A 56-year-old black man had a 10-year history of intermittent treatment for superficial pemphigus. Over the last 2 years, as his bullous disease had become more benign, hyperpigmented, warty lesions gradually developed on his back and chest. He was in good health, and the abnormal physical findings were confined to the skin. Over the back and upper extremities, there were numerous well-defined, raised, hyperpigmented, hyperkeratotic lesions ranging in diameter from 1 to 3 cm. The lesions on the back tended to follow the lines of skin cleavage and had an elongated shape (Fig 1). Most lesions

POEMS syndrome associated with cryoglobulinemia, lymphoma, multiple seborrheic keratosis, and ichthyosis

The case of a patient with POEMS syndrome is presented. The characteristic features of the disorder were associated with the apparently unique and undescribed findings of multiple seborrheic keratosis, ichthyosis, livedo reticularis, and vasculitis, combined with IgM/IgG cryoglobulinemia. Analysis of the cryoprecipitate revealed monoclonal IgM, with kappa light chains. Six years later an immunoblastic lymphoma developed. Notably, the paraneoplastic cutaneous signs were present 6 years before the development of the immunoblastic lymphoma.

Transitional Cell Carcinoma in the Muir-Torre Syndrome

The association of multiple sebaceous neoplasms and visceral malignancies is known as the Muir-Torre syndrome. We describe a patient who had papillary transitional cell carcinoma of the right renal pelvis resected in 1981 and papillary transitional cell carcinoma of the left renal pelvis removed surgically in 1983. Recurrent transitional cell carcinoma necessitated further resection of tumor in the right renal pelvis in 1983, right nephrectomy and partial ureterectomy in 1984, and removal of the right ureteral stump in 1985. History included multiple seborrheic keratoses, a keratoacanthoma and 4 sebaceous carcinomas between 1968 and 1985. In 1971 partial colectomy and jejunectomy were performed for stage D (Duke classification) adenocarcinoma of the transverse colon. Despite this the patient remains alive and well with no evidence of residual or metastatic disease.The Muir-Torre syndrome is a subtype of the cancer family syndrome, with gastrointestinal tract tumors being the most frequent visceral malignancies. Urinary tract carcinomas are present in just more than 10 per cent of the cases. This entity is discussed and the literature is reviewed with emphasis on the urological associations.

The Sign of Leser-Trélat in a Young Man

To the Editor.— The development of multiple seborrheic keratoses in a patient with an associated internal malignancy has been referred to as the sign of Leser-Trelat. This condition is almost always diagnosed in elderly people who have an underlying adenocarcinoma, usually of the gastrointestinal tract. We present the rare occurrence of multiple eruptive seborrheic keratoses in a 22-year-old man who had an intracranial tumor. The significance of this case is discussed herein with respect to the validity of the sign of Leser-Trelat. Report of a Case.— A 22-year-old man presented to the Letterman Army Medical Center, San Francisco, in August 1984, with persistent headaches, diplopia, and bilateral papilledema. Results of a computed tomographic scan revealed enlarged lateral and third ventricles, as well as an enlarged calcified pineal body. Results of a subsequent nuclear magnetic resonance study confirmed these findings and were suggestive of a germinoma. The α1-fetoprotein level was 22

Sign of Leser-Trélat: Report of two cases and review of the literature

The sudden appearance of multiple seborrheic keratoses in the two patients could be related to adenocarcinoma of the breast. Despite other isolated reports, this disorder is still controversial as a marker of malignancy.

Adenocarcinoma of the stomach with eruptive seborrheic keratoses: the sign of Leserp-Trélat.

The sign of Leser-Trélat, the sudden appearance of multiple seborrheic keratoses in conjunction with an internal malignancy, is very uncommon. A case involving a patient who had undergone resection of an adenocarcinoma of the sigmoid colon followed ten years later by the development of an adenocarcinoma of the stomach with exhibition of the sign of Leser-Trélat is presented. A summary of reported cases, along with a discussion of the sign, is provided. This is the first reported case of a patient presenting with the sign of Leser-Trélat along with a second primary malignancy.

The sign of Leser-Trélat in association with lymphocytic lymphoma.

The sign of Leser-Trélat was observed in a patient with multiple seborrheic keratoses and hemangiomata. The increase in these lesions of the skin preceded the development of a poorly differentiated lymphocytic lymphoma, a type of malignancy which has not yet been reported in association with this sign.

Renal Adenocarcinoma and Meningioma

To the Editor.— The association between eruptive seborrheic keratoses and internal malignancy has been reported before 1 and given the name of Leser-Trelat sign. 2 In previous reports the affected organs were as follows: adenocarcinoma of the stomach, four cases 3 ; adenocarcinoma of the large intestine, four cases 4 ; and adenocarcinoma of pancreas, 3 breast, 3 ovary, 1 uterus, 2 and prostate, 5 one case each. One patient had a squamous cell carcinoma of the lung 6 and one had Sezary syndrome. 1 Most of the patients were well over the age of 50 years. The time of eruption was short (between one and seven months). Report of a Case.— A 62-year-old woman was hospitalized for paresthesia and progressive weakness of the legs. During the previous five months she had noted onset of a large number of skin lesions on the head and trunk. On examination, multiple seborrheic keratoses were

Florid Cutaneous Papillomatosis

The abrupt onset of acanthosis nigricans (AN) or of multiple seborrheic keratoses in middle-aged or older people is often associated with underlying malignant neoplasms. We describe a 64-year-old woman who developed a large number of verrucous papillomas on the trunk and extremities, followed within a few months by the sudden appearance of both the lesions of AN and those of multiple seborrheic keratoses. Laparotomy disclosed a gastric adenocarcinoma. A number of similar cases have been described in the literature. It is emphasized that patients with suddenly appearing verrucous papillomas should be examined carefully for an underlying cancer. To call attention to this eruption, which may be mistaken for generalized warts, we suggest the term "florid cutaneous papillomatosis".

Florid cutaneous papillomatosis

• The abrupt onset of acanthosis nigricans (AN) or of multiple seborrheic keratoses in middle-aged or older people is often associated with underlying malignant neoplasms. We describe a 64-year-old woman who developed a large number of verrucous papillomas on the trunk and extremities, followed within a few months by the sudden appearance of both the lesions of AN and those of multiple seborrheic keratoses. Laparotomy disclosed a gastric adenocarcinoma. A number of similar cases have been described in the literature. It is emphasized that patients with suddenly appearing verrucous papillomas should be examined carefully for an underlying cancer. To call attention to this eruption, which may be mistaken for generalized warts, we suggest the term "florid cutaneous papillomatosis." (<i>Arch Dermatol</i>114:1803-1806, 1978)

Dermabrasion for showers of seborrheic keratoses.

Seborrheic keratoses, skin tumors of undetermined etiology, are easily traumatized with consequent local irritation and inflammation, and are cosmetically undesirable. They can occasionally undergo malignant degeneration. A rapid increase in size and number of these lesions is thought by many to be a sign of internal malignancy. Dermabrasion using a diamond fraise is a simple and fast method for removing multiple seborrheic keratoses with minimal trauma, rapid healing, and good cosmetic results.

The Sign of Leser-Trélat

<h3>To the Editor.—</h3> The sign of Leser-Trélat, ie, the development of multiple pruritic seborrheic keratoses, either preceding or concurrent with the development of internal carcinomas, is a sign which has not been totally accepted by the dermatologic community.¹Recently we saw a patient with a history of prostatic carcinoma who subsequently developed multiple seborrheic keratoses that were essentially asymptomatic. <h3>Report of a Case.—</h3> A 64-year-old man was seen in August 1974 with a chief complaint of "black moles of the back." He acknowledged the presence of this type of lesion for several years but sought medical attention at this time because of a sudden increase in their number during the preceding months. There was no history of pruritus. Medical history showed adenocarcinoma of the prostate first treated by transurethral resection in the spring of 1973. He was treated chemotherapeutically for recurrence of his genitourinary disorder in August 1974. Physical examination