Tags

Type your tag names separated by a space and hit enter

Sign and pseudo-sign of Leser-Trélat: case reports and a review of the literature.
J Drugs Dermatol. 2013 May; 12(5):e79-87.JD

Abstract

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.

METHODS

A literature review of SLT/PLT was performed by searching the PubMed database for all related English published cases.

RESULTS

We identified 109 cases of SLT and 12 cases of PLT, with a mean patient age of 61.8 years. SK eruptions were observed before (68.3%), after (22.1%), and at the time of (9.6%) malignancy diagnosis. The malignancy most frequently associated with SLT was gastric adenocarcinoma. The most common anatomical location of SK eruptions was the trunk (18.9%). Frequently reported associated signs and symptoms included pruritus (52%) and acanthosis nigricans (38.7%). The most common treatment included surgery (35.8%), chemotherapy (26.9%), and radiation therapy (26.9%). Treatment resulted in clinical improvement (45%), no change (30%), exacerbation (15%), or initial improvement followed by exacerbation of SKs. Patient outcomes included disease stability/ improvement (48.4%), recurrence (9.7%), exacerbation/metastasis/new malignancy (4.8%), and death (37.1%).

LIMITATIONS

This was a retrospective study and excluded non-English published cases.

CONCLUSION

This review updates the existing SLT literature and emphasizes the presence of PLT. Clinicians should be aware that SK eruptions may be early manifestations of an internal malignancy or other pathology. To our knowledge, this is the first review examining both SLT and PLT.

Links

Publisher Full Text

Authors+Show Affiliations

Husain Z
Georgetown University Hospital, Washington Hospital Center, Washington DC, USA.
Ho JK
No affiliation info available
Hantash BM
No affiliation info available

MeSH

Acanthosis NigricansAdenocarcinomaAged, 80 and overFemaleHumansKeratosis, SeborrheicMaleMiddle AgedNeoplasmsParaneoplastic SyndromesPruritusStomach Neoplasms

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

23652964

Citation

Husain, Zain, et al. "Sign and Pseudo-sign of Leser-Trélat: Case Reports and a Review of the Literature." Journal of Drugs in Dermatology : JDD, vol. 12, no. 5, 2013, pp. e79-87.
Husain Z, Ho JK, Hantash BM. Sign and pseudo-sign of Leser-Trélat: case reports and a review of the literature. J Drugs Dermatol. 2013;12(5):e79-87.
Husain, Z., Ho, J. K., & Hantash, B. M. (2013). Sign and pseudo-sign of Leser-Trélat: case reports and a review of the literature. Journal of Drugs in Dermatology : JDD, 12(5), e79-87.
Husain Z, Ho JK, Hantash BM. Sign and Pseudo-sign of Leser-Trélat: Case Reports and a Review of the Literature. J Drugs Dermatol. 2013;12(5):e79-87. PubMed PMID: 23652964.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sign and pseudo-sign of Leser-Trélat: case reports and a review of the literature. AU - Husain,Zain, AU - Ho,Joyce K, AU - Hantash,Basil M, PY - 2013/5/9/entrez PY - 2013/5/9/pubmed PY - 2013/12/16/medline SP - e79 EP - 87 JF - Journal of drugs in dermatology : JDD JO - J Drugs Dermatol VL - 12 IS - 5 N2 - 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. METHODS: A literature review of SLT/PLT was performed by searching the PubMed database for all related English published cases. RESULTS: We identified 109 cases of SLT and 12 cases of PLT, with a mean patient age of 61.8 years. SK eruptions were observed before (68.3%), after (22.1%), and at the time of (9.6%) malignancy diagnosis. The malignancy most frequently associated with SLT was gastric adenocarcinoma. The most common anatomical location of SK eruptions was the trunk (18.9%). Frequently reported associated signs and symptoms included pruritus (52%) and acanthosis nigricans (38.7%). The most common treatment included surgery (35.8%), chemotherapy (26.9%), and radiation therapy (26.9%). Treatment resulted in clinical improvement (45%), no change (30%), exacerbation (15%), or initial improvement followed by exacerbation of SKs. Patient outcomes included disease stability/ improvement (48.4%), recurrence (9.7%), exacerbation/metastasis/new malignancy (4.8%), and death (37.1%). LIMITATIONS: This was a retrospective study and excluded non-English published cases. CONCLUSION: This review updates the existing SLT literature and emphasizes the presence of PLT. Clinicians should be aware that SK eruptions may be early manifestations of an internal malignancy or other pathology. To our knowledge, this is the first review examining both SLT and PLT. SN - 1545-9616 UR - https://www.unboundmedicine.com/medline/citation/23652964/Sign_and_pseudo_sign_of_Leser_Trélat:_case_reports_and_a_review_of_the_literature_ L2 - http://jddonline.com/articles/dermatology/S1545961613E0079X DB - PRIME DP - Unbound Medicine ER -