Case Rep Dermatol 2017 May-Aug;9(2):35-39. Epub 2017 Jun 8.

Department of Dermatology, CHU Sart Tilman, University of Liège, Liège, Belgium.

Eruptive seborrheic keratoses (ESK) are rare in dermatology. They are usually inflammatory in nature and may be encountered as Leser-Trélat sign. ESK may also be simultaneously observed with hepatic angiomas, chemotherapy, segmental neurofibromatosis, HIV or erythrodermic pityriasis rubra pilaris, psoriasis, and drug eruption. Read More

Dermatol Online J 2017 Jan 15;23(1). Epub 2017 Jan 15.

School of Medicine, University of California San Diego.

Background: The sign of Leser-Trélat is characterizedby the sudden appearance of seborrheic keratosesassociated with an underlying malignancy.

Objectives: An elderly man who developed multiple new-onsetseborrheic keratoses temporally associated witha diagnosis of mycosis fungoides is described andlymphoma-associated Leser-Trélat sign is reviewed.

Methods: Pubmed was used to search the followingterms: cutaneous T-cell lymphoma, Leser-Trélat,leukemia, lymphoma, mycosis fungoides, and Sézarysyndrome. Read More

Case Rep Med 2016 23;2016:4259190. Epub 2016 Nov 23.

Internal Medicine Department, Clinics Hospital of the Federal University of Paraná, Curitiba, PR, Brazil.

Introduction. Skin disorders can be the first manifestation of occult diseases. The recognition of typical paraneoplastic dermatoses may anticipate the cancer diagnosis and improve its prognosis. Read More

Dermatol Online J 2016 Apr 18;22(4). Epub 2016 Apr 18.

Department of Dermatology and Itch Center, Temple University School of Medicine.

A 71-year-old man presented with numerous pruritic seborrheic keratoses, with an eruptive onset over the course of 3 months. At presentation, he was also found to have hypopigmented tumors diffusely scattered throughout his body that were found to be mycosis fungoides on histologic examination. A theory regarding the pathophysiology of the development of eruptive seborrheic keratoses in the presence of mycosis fungoides is briefly discussed and 10 previous case reports of the Leser-Trélat sign in the setting of mycosis fungoides are reviewed. Read More

Semin Oncol 2016 Jun 23;43(3):366-9. Epub 2016 Feb 23.

University of Louisville, Division of Dermatology, Louisville, KY. Electronic address:

Skin findings can serve as a clue to internal disease. In this article, cutaneous manifestations of underlying lung malignancy are reviewed. Paraneoplastic dermatoses are rare, but when recognized early, can lead to early diagnosis of an underlying neoplasm. Read More

Diabetol Metab Syndr 2016 29;8:33. Epub 2016 Apr 29.

Endocrinology Division, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP Brazil.

A rare sign of some malignant tumors is a sudden eruption of multiple seborrheic keratoses called Leser-Trélat sign. Overproduction of insulin-like growth factor-2 (IGF2) or its precursor is the main mechanism related to non-islet cell tumor hypoglycemia. Doege-Potter syndrome is the name given to paraneoplastic hypoinsulinemic hypoglycemia in presence of a solitary fibrous tumor. Read More

BMJ Case Rep 2016 Apr 8;2016. Epub 2016 Apr 8.

Department of General Medicine, Mackay Hospital and Health Service, Mackay, Queensland, Australia.

Med Clin (Barc) 2016 May 28;146(10):470. Epub 2016 Jan 28.

Equipo de Cuidados Paliativos de Badajoz, Programa Regional de Cuidados Paliativos de Extremadura, Badajoz, España. Electronic address:

Indian J Dermatol Venereol Leprol 2016 Jan-Feb;82(1):112

Department of Dermatology, Venereology and Leprology, Government Medical College, Kota, Rajasthan, India.

J Community Support Oncol 2015 Apr;13(4):156-8

Hematology-Oncology Section, Department of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

Distant gastric metastasis to the skin is uncommonly a presenting symptom, although nonspecific paraneoplastic syndromes with dermatologic manifestation including diffuse seborrheic keratoses (Leser-Trelat sign), tripe palms, and acanthosis nigricans have been described in the literature. We report here the case of a 49-year-old woman with gastric adenocarcinoma who presented with cutaneous metastasis as an initial symptom. In our case, metastatic skin lesions responded significantly to EOX chemotherapy (epirubicin+oxaliplatin+capecitabine) despite progression of systemic disease. Read More

Indian J Dermatol Venereol Leprol 2015 May-Jun;81(3):320-1

Department of Dermatology, No. 1 Hospital of China Medical University, Shenyang, China.

Cutis 2014 Nov;94(5):E14-5

Senevler mah 6139, Sok Saygınkent sitesi C blok no 3, Sanliurfa, Turkey.

Int J Dermatol 2015 11;54(5):e146-8. Epub 2014 Jul 11.

Department of Dermatology, Laboratory Medicine and Pathology, Rochester, MN, USA.

J Am Osteopath Assoc 2014 Jul;114(7):593

From the Internal Medicine-Pediatrics Residency Program at the University of Missouri School of Medicine in Columbia.

Rev Gastroenterol Mex 2014 Oct-Dec;79(4):294-5. Epub 2014 Jun 16.

Departamento de Cirugía de Colon y Recto y Departamento de Dermatología, Hospital Guadalupano de Celaya, Celaya Guanajuato, México.

Skinmed 2014 Mar-Apr;12(2):76-8

Case Rep Oncol Med 2014 6;2014:825929. Epub 2014 Feb 6.

Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Avenue, Suite No. 10C, Bronx, NY 10457, USA.

The sign of Leser-Trélat is a rare paraneoplastic phenomenon marked by accelerated onset of multiple seborrheic keratoses. The occurrence of the sign often points towards underlying visceral malignancies which in a majority are adenocarcinomas of the gastrointestinal tract. We report this case of a 65-year-old man who presented with sign of Leser-Trélat and was diagnosed with poorly differentiated squamous cell cancer of the esophagus. Read More

Acta Clin Belg 2013 Sep-Oct;68(5):391-2

J Drugs Dermatol 2014 Jan;13(1):14

Acta Dermatovenerol Croat 2013 ;21(2):123-7

Department of Dermatology, Faculty of Medicine, University of Harran, 63200-Sanliurfa, Turkey.

Leser-Trélat sign is a rare cutaneous disorder that manifests with sudden emergence of seborrheic keratoses and increase in their numbers and size within weeks or months. Its concurrence with many types of malignancies, especially adenocarcinoma and lymphoma, has been reported in the literature. In this case report, a patient having Leser-Trélat sign, without any detected malignancy in spite of detailed examination and 18 months of follow up, is presented. Read More

J Dermatol Case Rep 2013 Jun 30;7(2):60-3. Epub 2013 Jun 30.

University of Washington School of Medicine, Seattle, WA, USA;

Background: Seborrheic keratoses are common, benign cutaneous growths, however in rare situations they can acutely erupt in large numbers. Eruptive seborrheic keratoses can be associated with internal malignancy (sign of Leser-Trelat), but may also appear in conjunction with inflammatory dermatoses and adverse drug reactions.

Main Observation: A 71-year-old Caucasian man presented with acute onset of a pruritic, burning papular erythematous rash on his chest, upper extremities and lower extremities after a routine adalimumab injection for rheumatoid arthritis. Read More

Rev Med Chil 2012 Dec;140(12):1585-8

Servicio Urgencias, Hospital Víctor Río Ruiz, Los Ángeles, Chile.

We report a 66-year-old male presenting with malaise, heartburn and pruritic seborrheic keratoses in both feet of sudden onset, suggesting a Leser-Trélat sign. An upper gastrointestinal endoscopy disclosed a gastric cancer. The patient was subjected to a total gastrectomy and during follow up, the skin lesions had disappeared. Read More

Int J Dermatol 2015 Mar 15;54(3):338-42. Epub 2013 May 15.

Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 430022.

World J Hepatol 2013 Apr;5(4):230-3

Qing-Feng Ni, Guo-Qing Liu, Li-Yong Pu, Liang-Liang Kong, Lian-Bao Kong, Department of Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, The National Institute of Living Donor Liver Transplantation, Nanjing 210029, Jiangsu Province, China.

Patients with gallbladder carcinoma can present with a variety of paraneoplastic syndromes, including Cushing's syndrome, hypercalcemia, acanthosis nigricans, bullous pemphigoid, dermatomyositis and the sign of Leser-Trélat. Surgical resection of the primary tumor results in resolution of these paraneoplastic syndromes. We present a 67-year old female with facial and cervical erythema who was initially diagnosed with dermatomyositis. Read More

J Drugs Dermatol 2013 May;12(5):e79-87

Georgetown University Hospital, Washington Hospital Center, Washington DC, USA.

Background: Leser-Trélat is distinguished by a rare paraneoplastic sign that is characterized by the sudden eruption of multiple seborrheic keratoses (SKs), associated with underlying internal malignancies. Similar non-malignancy-associated SK eruptions are referred to as the "pseudo-sign of Leser-Trélat" (PLT).

Objective: Two cases of rapid SK eruptions, one the sign of Leser-Trélat (SLT) and one PLT, are presented, and the literature on SLT and PLT is reviewed. Read More

An Bras Dermatol 2013 Jan-Feb;88(1):9-22

Catholic University of Brasília- UCB, Brasília, (DF), Brazil.

The skin often signals systemic changes. Some neoplastic diseases that affect internal organs may trigger several cutaneous manifestations. Although these dermatoses are relatively unusual, the recognition of some typical paraneoplastic dermatoses may lead to the early diagnosis of a neoplasm and determine a better prognosis. Read More

Endocr Pract 2013 May-Jun;19(3):522-5

Northeast Ohio Medical University, Rootstown, Ohio, USA.

Objective: To review common skin manifestations associated with type 2 diabetes mellitus (DM), and to discuss a potential underlying mechanism for these manifestations.

Methods: A PubMed literature search was conducted for articles describing the skin manifestations associated with hyperinsulinemia and type 2 DM. A case presentation describes a morbidly obese patient with type 2 DM treated with metformin who developed acanthosis nigricans, finger pebbles, scores of skin tags (acrochordons), and the sign of Leser-Trélat (sudden onset shower of seborrheic keratoses) in the absence of internal malignancy. Read More

J Am Acad Dermatol 2013 Feb;68(2):189.e1-21; quiz 210

Division of Dermatology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas 75246, USA.

Cutaneous findings are not uncommonly a concomitant finding in patients afflicted with gastrointestinal (GI) diseases. The dermatologic manifestations may precede clinically evident GI disease. Part I of this 2-part CME review focuses on dermatologic findings as they relate to hereditary and nonhereditary polyposis disorders and paraneoplastic disorders. Read More

Lancet 2013 Jan;381(9860):88

Department of Obstetrics and Gynaecology, Oncology and high risk pregnancies, Maternity Hospital Souissi, University teaching hospital Ibn Sina of Rabat, Rabat, Morocco.

Cutis 2012 Nov;90(5):235-6

Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Leser-Trélat sign is a controversial paraneoplastic phenomenon characterized by an eruption of seborrheic keratoses (SKs). We report a rare case of eruptive inflammatory SKs in a man undergoing induction chemotherapy for acute myeloid leukemia (AML). We also review the literature on Leser-Trélat sign. Read More

Lancet 2013 May 30;381(9878):1653. Epub 2012 Nov 30.

Department of Dermatology, Venereology and Allergology, University School of Medicine Essen-Duisburg, Essen, Germany.

Case Rep Oncol 2012 Sep 25;5(3):576-9. Epub 2012 Oct 25.

Johns Hopkins University/Sinai Hospital of Baltimore, Department of Internal Medicine, Baltimore, Md., USA.

We report the case of a 79-year-old Caucasian man, who developed numerous pruritic seborrheic keratoses on his chest and back within one year. An underlying malignant disease was suspected. Upper and lower endoscopies were performed and the patient was diagnosed with adenocarcinoma of the ascending colon. Read More

Cutis 2012 Jan;89(1):33-5

Naval Hospital, Jacksonville, Florida, USA.

The presence of multiple seborrheic keratoses appearing abruptly in association with an underlying malignancy is known as Leser-Trélat sign, a rare paraneoplastic cutaneous syndrome. Although this finding is most commonly associated with solid organ tumors, it also can be a clue for the presence of underlying hematologic malignancies. We present a unique case of Leser-Trélat sign in a 20-year-old man who experienced a relapse of pre-B-cell acute lymphocytic leukemia (ALL) that was previously treated with multiple courses of chemotherapy and external radiation therapy. Read More

Clin Dermatol 2011 Sep-Oct;29(5):541-7

Sector of Dermatology and Post Graduation Course of Dermatology, University Hospital Clementino Fraga Filho andSchool of Medicine, Federal University of Rio de Janeiro, 22280-020 Rio de Janeiro, Brazil.

Paraneoplasias are frequently the first sign of a subjacent malignant tumor. Although relatively rare, they need to be recognized by dermatologists to make an early diagnosis and improve the prognosis related especially to the neoplasia. This contribution presents the morphologic aspects and the differential diagnosis of the main paraneoplasias, which include acanthosis nigricans, tripe palms, Leser-Trélat sign, acquired ichthyosis, acquired hypertrichosis lanuginosa, pityriasis rotunda, erythema gyratum repens, palmo-plantar keratoderma, Bazex syndrome, and dermatomyositis, hoping to contribute to the familiarity of dermatologists with the identification and early diagnosis of this group. Read More

Case Rep Oncol 2011 Mar 29;4(1):175-7. Epub 2011 Mar 29.

Department of Dermatology, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, France.

Leser-Trélat sign is characterized by the abrupt appearance of multiple seborrheic keratoses in association with underlying malignant disease. A case of Leser-Trélat sign in a 66-year-old healthy woman is presented. Evaluation and follow-up for the development of malignancy over a 2-year period failed to reveal any evidence of malignancy. Read More

Ann Hematol 2011 Mar 12;90(3):363. Epub 2010 Aug 12.

Am Surg 2010 Mar;76(3):340-1

J Hematol Oncol 2010 Jan 11;3. Epub 2010 Jan 11.

Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy.

Leser-Trélat syndrome is characterized by the eruptive appearance of multiple seborrheic keratoses in association with underlying malignant disease. Usually, the sign of Leser-Trélat is associated with adenocarcinoma, most frequently of the colon, breast, or stomach, but also of the lung, kidney, liver, and pancreas. Herein, we present a case that we believe is the first report of the sign of Leser-Trélat in association with occult gastric adenocarcinoma and the anamnestic oncologic history of five other multiple primitive cancers. Read More

Cases J 2009 Aug 26;2:8868. Epub 2009 Aug 26.

Service de Dermatologie, Universite Montpellier I, Hopital Saint-Eloi CHU de Montpellier, 80, Avenue Augustin Fliche, FR-34295 Montpellier Cedex 5, France.

Introduction: The sign of Leser-Trélat is defined by the sudden appearance and rapid increase in number and size of seborrheic keratoses, preceding or revealing a malignancy. Even though this sign remains controversial, it has been described during a wide range of malignancies, including mainly adenocarcinoma of the gastro-intestinal tract or the breast.

Case Presentation: We report the case of a 68-year-old man who experienced sudden increased in number of seborrheic keratoses within two years prior to a diagnosis of adenocarcinoma of the prostate. Read More

J Med Case Rep 2009 Jul 23;3:8583. Epub 2009 Jul 23.

Introduction: Seborrheic keratoses are very common findings in elderly patients. However, a sudden onset and dramatic increase in the number and size of these benign lesions deserves special attention, since this may represent the Leser Trélat sign, a rare paraneoplastic cutaneous syndrome.

Case Presentation: A 92-year-old female presented to our clinic with multiple eruptive seborrheic keratoses, which had dramatically increased in size and number over the past two years. Read More

J Am Acad Dermatol 2009 Sep;61(3):538-40

Int J Dermatol 2009 Aug;48(8):912-3

J Am Acad Dermatol 2009 May;60(5):852-5

Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.

Paraneoplastic signs are an important clue to diagnosing an associated malignancy. We report an unusual variant of the sign of Leser-Trélat in a patient with a low-grade B-cell lymphoproliferative disorder and intertriginous skin spicules with histologic morphology of minute seborrheic keratoses. Read More

J Eur Acad Dermatol Venereol 2009 Nov 4;23(11):1316-9. Epub 2009 Mar 4.

Department of Dermatology, Wilhelminenspital, Vienna, Austria.

Background: The association between the eruption of numerous seborrhoeic keratoses as a result of an underlying malignancy is controversially discussed. The aim of this case-control study with prospective accrual of patients was to determine whether a direct association exists between the number seborrhoeic keratoses and internal malignancies.

Methods: The numbers and sites of seborrhoeic keratoses were counted in 150 oncological patients and 150 matched controls. Read More

Ann Diagn Pathol 2009 Apr 11;13(2):124-6. Epub 2008 Jan 11.

Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

A small number of patients with carcinoma of the gallbladder can present with a variety of paraneoplastic syndromes, including the Cushing syndrome, hypercalcemia, acanthosis nigricans, bullous pemphigoid, dermatomyositis, and the Leser-Trélat sign. We report on what appears to be the first case of a patient, a 48-year-old woman, with anti-Hu paraneoplastic sensory neuropathy and small cell carcinoma of the gallbladder. The patient's neurologic symptoms preceded the diagnosis of small cell carcinoma by 11 months. Read More

South Med J 2009 Feb;102(2):216-8

Georgetown University, Washington, DC, USA.

We present a case featuring a unique overlap between the body areas involved by lung adenocarcinoma and the cutaneous paraneoplastic sign of Leser-Trélat. In our patient, the Leser-Trélat sign consisted of explosive multiple seborrheic keratoses in combination with acanthosis nigricans, representing a remarkable geometric skin projection of lung cancer which involved both the upper lobes. Our case suggests a unique interrelation between the paraneoplastic sign of Leser-Trélat and the tumor itself. Read More

Clin Exp Dermatol 2009 Jan;34(1):52-4

Department of Dermatology, Wuxi Second Affiliated Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.

The sign of Leser-Trélat (LT) is defined as the sudden eruption of multiple seborrhoeic keratoses (SKs), or increase in the number and size of existing SKs, associated with an underlying malignancy. A 75-year-old man was admitted to our hospital with dyspnoea and multiple verrucous papules that had been developing gradually over the previous 30 years. During the 3 months before presentation, the number of SKs on his chest and back had increased rapidly. Read More

J Clin Oncol 2008 Oct 22;26(30):4992-3. Epub 2008 Sep 22.

Harvard Radiation Oncology Program, Boston, MA, USA.

Int J Dermatol 2008 Jun;47(6):643-4

Ann Dermatol Venereol 2008 Apr 25;135(4):287-90. Epub 2008 Mar 25.

Service de dermatologie, hôpital Fournier, CHU de Nancy, 36, quai de la Bataille, 54000 Nancy, France.

Background: Leser-Trélat sign involves the combined sudden onset of seborrheic keratosis and cancer. However, some doubt surrounds the existence of this syndrome. We report a case of Leser-Trélat sign that led to the discovery of Sézary syndrome. Read More