Sign of Leser-Trelat Differential Diagnoses

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 18, 2012
 
 
 
Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Takeji Nishikawa, MD  Emeritus Professor, Department of Dermatology, Keio University School of Medicine; Director, Samoncho Dermatology Clinic; Managing Director, The Waksman Foundation of Japan Inc

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Warren R Heymann, MD  Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
  1. Leser E. Ueber ein die Krebskrankheit beim Menschen haufig begleitendes, noch wenig gekanntes Symptom. Munchener Med Wochenschr. 1901;51:2035-2036.

  2. De Bersaques J. Sign of Leser-Trelat. J Am Acad Dermatol. 1985;12:724.

  3. Hollander E. V. Beitrage zur Fruhdiagnose des Darmcarcinomas (Hereditatsverhaltnisse und Hautveranderungen. Deutsche Medicinische Wochenschrift. 1900;26:483-485.

  4. Dubreuilh W. Official Transactions. Des hyperkeratoses circonscrites. Third International Congress of Dermatology held in the examination hall of the conjoint Royal Colleges of Physicians and Surgeons, London: Waterlow & Sons Ltd; August 4-8, 1896.

  5. Freudenthal W. Verruca senilis und Keratoma senile. Arch F Dermat U Syph (Berlin). 1926;152:505-528.

  6. Garcia RL, Bishop ME. The rapid onset of seborrheic keratoses of the breasts during pregnancy. J Assoc Mil Dermatol. 1977;3 (2):13-4.

  7. Lindelöf B, Sigurgeirsson B, Melander S. Seborrheic keratoses and cancer. J Am Acad Dermatol. Jun 1992;26(6):947-50. [Medline].

  8. Kilmer SL, Berman B, Morhenn VB. Eruptive seborrheic keratoses in a young woman with acromegaly. J Am Acad Dermatol. Nov 1990;23(5 Pt 2):991-4. [Medline].

  9. Martin RW 3rd, Rady P, Arany I, Tyring SK. Benign Leydig cell tumor of the testis associated with human papillomavirus type 33 presenting with the sign of Leser-Trelat. J Urol. Oct 1993;150(4):1246-50. [Medline].

  10. Inamadar AC, Palit A. Eruptive seborrhoeic keratosis in human immunodeficiency virus infection: a coincidence or 'the sign of Leser-Trelat'?. Br J Dermatol. Aug 2003;149(2):435-6. [Medline].

  11. Millard LG, Gould DJ. Hyperkeratosis of the palms and soles associated with internal malignancy and elevated levels of immunoreactive human growth hormone. Clin Exp Dermatol. Dec 1976;1(4):363-8. [Medline].

  12. Ellis DL, Kafka SP, Chow JC, et al. Melanoma, growth factors, acanthosis nigricans, the sign of Leser-Trelat, and multiple acrochordons. A possible role for alpha-transforming growth factor in cutaneous paraneoplastic syndromes. N Engl J Med. Dec 17 1987;317(25):1582-7. [Medline].

  13. Horiuchi Y, Katsuoka K, Takezaki S, Nishiyama S. Study of epidermal growth activity in cultured human keratinocytes from peripheral-blood lymphocytes of a patient with Sezary syndrome associated with the Leser-Trelat sign. Arch Dermatol Res. 1985;278(1):74-6. [Medline].

  14. Ellis DL, Yates RA. Sign of Leser-Trelat. Clin Dermatol. Jan-Mar 1993;11(1):141-8. [Medline].

  15. Ponti G, Luppi G, Losi L, Giannetti A, Seidenari S. Leser-Trélat syndrome in patients affected by six multiple metachronous primitive cancers. J Hematol Oncol. Jan 11 2010;3:2. [Medline]. [Full Text].

  16. Barron LA, Prendiville JS. The sign of Leser-Trelat in a young woman with osteogenic sarcoma. J Am Acad Dermatol. Feb 1992;26(2 Pt 2):344-7. [Medline].

  17. Westrom DR, Berger TG. The sign of Leser-Trelat in a young man. Arch Dermatol. Dec 1986;122(12):1356-7. [Medline].

  18. Schwengle LE, Rampen FH, Wobbes T. Seborrhoeic keratoses and internal malignancies. A case control study. Clin Exp Dermatol. May 1988;13(3):177-9. [Medline].

  19. Grob JJ, Rava MC, Gouvernet J, et al. The relation between seborrheic keratoses and malignant solid tumours. A case-control study. Acta Derm Venereol. 1991;71(2):166-9. [Medline].

  20. Kierland RR. Acanthosis nigricans: an analysis of data in twenty-two cases and a study of its frequency in necropsy material. J Invest Dermatol. 1947;9:299-305.

  21. Li M, Yang LJ, Zhu XH, et al. The Leser-Trelat sign is associated with nasopharyngeal carcinoma: case report and review of cases reported in China. Clin Exp Dermatol. Jan 2009;34(1):52-4. [Medline].

  22. Yavasoglu I, Kadikoylu G, Bolaman Z. The Leser-Trelat sign is a associated with acute myeloid leukemia. Ann Hematol. Mar 2011;90(3):363. [Medline].

  23. Fasoldt JJ, Brumwell ER, Lackey JN. Leser-Trélat sign presenting in a patient with recurrent pre-B-cell acute lymphocytic leukemia. Cutis. Jan 2012;89(1):33-5. [Medline].

  24. Siedek V, Schuh T, Wollenberg A. Leser-Trelat sign in metastasized malignant melanoma. Eur Arch Otorhinolaryngol. Feb 2009;266(2):297-9. [Medline].

  25. Fink AM, Filz D, Krajnik G, Jurecka W, Ludwig H, Steiner A. Seborrhoeic keratoses in patients with internal malignancies: a case-control study with prospective accrual of patients. J Eur Acad Dermatol Venereol. Nov 2009;23(11):1316-9. [Medline].

  26. Bedi TR. Familial congenital multiple seborrheic verrucae. Arch Dermatol. Oct 1977;113(10):1441-2. [Medline].

  27. Jadassohn J. Die benignen Epitheliome. Arch f Dermatol u Syph (Wien). 1913;116:117.

  28. Reiches AJ. Seborrheic keratoses; are they delayed hereditary nevi?. AMA Arch Derm Syphilol. May 1952;65(5):596-600. [Medline].

  29. Rongioletti F, Corbella L, Rebora A. Multiple familial seborrheic keratoses. Dermatologica. 1988;176(1):43-5. [Medline].

  30. Dasanu CA, Alexandrescu DT. Bilateral Leser-Trelat sign mirroring lung adenocarcinoma with early metastases to the contralateral lung. South Med J. Feb 2009;102(2):216-8. [Medline].

  31. Janniger EJ, Schwartz RA. Florid cutaneous papillomatosis. J Surg Oncol. Nov 1 2010;102(6):709-12. [Medline].

  32. Jemec GB. Hypertrichosis lanuginosa acquisita. Report of a case and review of the literature. Arch Dermatol. Jul 1986;122(7):805-8. [Medline].

  33. Hage E, Hage J. Malignant acanthosis nigricans--a para-endocrine syndrome?. Acta Derm Venereol. 1977;57(2):169-72. [Medline].

  34. Aylesworth R, Vance JC. Multiple hamartoma syndrome with endometrial carcinoma and the sign of Leser-Trelat. Arch Dermatol. Feb 1982;118(2):136-8. [Medline].

  35. Rubisz-Brzezinska J, Zebracka T, Musialowicz D. [Coexistence of 2 paraneoplastic syndromes - acrokeratosis bazex and Leser-Trelat syndrome - in a case of squamous-cell laryngeal cancer]. Przegl Dermatol. Mar-Apr 1983;70(2):205-8. [Medline].

  36. Kebria MM, Belinson J, Kim R, Mekhail TM. Malignant acanthosis nigricans, tripe palms and the sign of Leser-Trelat, a hint to the diagnosis of early stage ovarian cancer: a case report and review of the literature. Gynecol Oncol. May 2006;101(2):353-5. [Medline].

  37. da Rosa AC, Pinto GM, Bortoluzzi JS, Duquia RP, de Almeida HL Jr. Three simultaneous paraneoplastic manifestations (ichthyosis acquisita, Bazex syndrome, and Leser-Trélat sign) with prostate adenocarcinoma. J Am Acad Dermatol. Sep 2009;61(3):538-40. [Medline].

  38. Pembroke AC, Grice K, Levantine AV, Warin AP. Eruptive angiomata in malignant disease. Clin Exp Dermatol. Jun 1978;3(2):147-56. [Medline].

  39. Siedek V, Schuh T, Wollenberg A. Leser-Trelat sign in metastasized malignant melanoma. Eur Arch Otorhinolaryngol. Feb 2009;266(2):297-9. [Medline].

  40. Patton T, Zirwas M, Nieland-Fisher N, Jukic D. Inflammation of seborrheic keratoses caused by cytarabine: a pseudo sign of Leser-Trelat. J Drugs Dermatol. Sep-Oct 2004;3(5):565-6. [Medline].

  41. Peterson J, Shook BA, Wells MJ, Rodriguez M. Cupric keratosis: green seborrheic keratoses secondary to external copper exposure. Cutis. Jan 2006;77(1):39-41. [Medline].

  42. Pastar Z, Lipozencic J, Rados J, Stajminger G. Regressing seborrheic keratosis - clinically and dermoscopically mimicking a regressing melanoma. Acta Dermatovenerol Croat. 2007;15(1):24-6. [Medline].

  43. Stieler W, Plewig G. [Acanthosis nigricans maligna and Leser-Trélat sign in double malignancy of the breast and stomach]. Z Hautkr. Mar 1 1987;62(5):344-66. [Medline].

  44. Holdiness MR. A case of Leser-Trélat sign. J Am Acad Dermatol. Jan 1987;16(1 Pt 1):147-8. [Medline].

  45. Abeloff MD. Paraneoplastic syndromes: a window on the biology of cancer. N Engl J Med. Dec 17 1987;317(25):1598-600. [Medline].

  46. Achten G, Ledoux-Corbusier M, Goens J. [Classification and pathogenesis of cutaneous paraneoplastic syndromes]. Ann Med Interne (Paris). 1984;135(8):646-53. [Medline].

  47. Balo J. A verrucak es rak gyakori egyuttes elofordulasa. Orvosi Hetilop. 1933;77:797-798.

  48. Barth G, Basten O, Ruschoff J, Rompel R. [Clinical and histopathological characteristics of early Leser-Trelat syndrome]. Hautarzt. Jul 2001;52(7):649-52. [Medline].

  49. Bordeleau L, Weatherhead L. Eruptive seborrheic keratoses and Crohn's disease. Canadian J Dermatol. 1993;5:495-496.

  50. Brauer J, Happle R, Gieler U. The sign of Leser-Trelat: fact or myth?. J Europ Acad Dermatol Venereol. 1992;1:77-80.

  51. Carrera C, Segura S, Palou J, et al. Seborrheic keratosislike melanoma with folliculotropism. Arch Dermatol. Mar 2007;143(3):373-6. [Medline].

  52. Ceylan C, Alper S, Kilinc I. Leser-Trelat sign. Int J Dermatol. Oct 2002;41(10):687-8. [Medline].

  53. Curth HO. Skin lesions and internal carcinoma. In: Cancer of the Skin. Biology-Diagnosis-Management. Philadelphia, Pa: WB Saunders; 1976:1308-41.

  54. Curth HO. Skin manifestations of internal malignant tumors. Md State Med J. Dec 1972;21(12):52-6. [Medline].

  55. Dantzig PI. Sign of Leser-Trelat. Arch Dermatol. Nov 1973;108(5):700-1. [Medline].

  56. Darier J. Authorized translation from the second French edition edited with notes by S. Pollitzer. Philadelphia, Pa: Lea & Febinger; 1920:209-10.

  57. De Bersaques J, Dockx P. [Internal malignant tumors and cutaneous symptoms]. Arch Belg Dermatol. Jul-Sep 1974;30(3):117-58. [Medline].

  58. Dingley ER, Marten RH. Adenocarcinoma of the ovary presenting as acanthosis nigricans. J Obstet Gynaecol Br Emp. Dec 1957;64(6):898-900. [Medline].

  59. Flugman SL, McClain SA, Clark RA. Transient eruptive seborrheic keratoses associated with erythrodermic psoriasis and erythrodermic drug eruption: report of two cases. J Am Acad Dermatol. Dec 2001;45(6 Suppl):S212-4. [Medline].

  60. Follmann J. A naevusok gyakorisagarol valamint a naevusok es a kozotti osszefuggesekrol. Magyar Orvosi Archivum. 1939;40:53-71.

  61. Freudenthal W. Rumpfhautepitheliom (nebst Bemerkungen uber die Verruca senilis und das Keratoma senilis. Arch F Dermat U Syph (Berlin). 1929;158:539-544.

  62. Gheeraert P, Goens J, Schwartz RA, Lambert WC, Schroeder F, Debusscher L. Florid cutaneous papillomatosis, malignant acanthosis nigricans, and pulmonary squamous cell carcinoma. Int J Dermatol. Mar 1991;30(3):193-7. [Medline].

  63. Heng MC, Soo-Hoo K, Levine S, Petresek D. Linear seborrheic keratoses associated with underlying malignancy. J Am Acad Dermatol. Jun 1988;18(6):1316-21. [Medline].

  64. Hirano T, Yoshioka H, Manabe T. A case of pancreatic cancer with the sign of Leser-Trelat. Nippon Geka Hokan. Jul 1 1993;62(4):203-8. [Medline].

  65. Holdiness MR. Erythroderma, seborrheic keratoses and Leser-Trelat sign. Acta Derm Venereol. 1989;69(3):273-4. [Medline].

  66. Holdiness MR. On the classification of the sign of Leser-Trelat. J Am Acad Dermatol. Oct 1988;19(4):754-7. [Medline].

  67. Holdiness MR. The sign of Leser-Trelat. Int J Dermatol. Nov 1986;25(9):564-72. [Medline].

  68. Hollander E. Carcinom und Hautveranderungen. Centralblatt F Chirurg. 1902;29:457-459.

  69. Klimopoulos S, Kounoudes C, Pantelidaki C, Skrepetou K, Papoudos M, Katsoulis H. The leser-trelat sign in association with carcinoma of the ampulla of Vater. Am J Gastroenterol. May 2001;96(5):1623-6. [Medline].

  70. Micali G, Nasca MR, Pasquale R. Familial multiple seborrheic keratoses. Report of a kindred. Giornale Ital Dermatol Venerol. 2002;137:169.

  71. Moore RL, Devere TS. Epidermal manifestations of internal malignancy. Dermatol Clin. Jan 2008;26(1):17-29, vii. [Medline].

  72. Pentenero M, Carrozzo M, Pagano M, Gandolfo S. Oral acanthosis nigricans, tripe palms and sign of leser-trelat in a patient with gastric adenocarcinoma. Int J Dermatol. Jul 2004;43(7):530-2. [Medline].

  73. Rampen HJ, Schwengle LE. Erythroderma, seborrheic keratoses and Leser-Trelat sign. Response to Dr. Mark Holdiness' letter. Acta Derm Venereol (Stockh). 1989;60:273-274.

  74. Rampen HJ, Schwengle LE. The sign of Leser-Trelat: does it exist?. J Am Acad Dermatol. Jul 1989;21(1):50-5. [Medline].

  75. Ronchese F. Keratoses, cancer and "the sign of Leser-Trelat". Cancer. Aug 1965;18:1003-6. [Medline].

  76. Schwartz RA. Acanthosis nigricans, florid cutaneous papillomatosis and the sign of Leser-Trelat. Cutis. Sep 1981;28(3):319-22, 326-7, 330-1 passim. [Medline].

  77. Schwartz RA. Acanthosis nigricans. J Am Acad Dermatol. Jul 1994;31(1):1-19; quiz 20-2. [Medline].

  78. Schwartz RA. The sign of leser-trelat. In: Demis DJ, ed. Clinical Dermatology. 26A. 13th ed. Philadelphia, Pa: JB Lippincott; 1987:1-3.

  79. Schwartz RA. Florid cutaneous papillomatosis. Clin Dermatol. Jan-Mar 1993;11(1):89-91. [Medline].

  80. Schwartz RA. Sign of Leser-Trelat. J Am Acad Dermatol. Jul 1996;35(1):88-95. [Medline].

  81. Schwartz RA, Burgess GH. Florid cutaneous papillomatosis. Arch Dermatol. Dec 1978;114(12):1803-6. [Medline].

  82. Schwartz RA, Helmold ME, Janniger CK, Gascon P. Sign of Leser-Trelat with a metastatic mucinous adenocarcinoma. Cutis. Apr 1991;47(4):258-60. [Medline].

  83. Scully C, Barrett WA, Gilkes J, Rees M, Sarner M, Southcott RJ. Oral acanthosis nigricans, the sign of Leser-Trelat and cholangiocarcinoma. Br J Dermatol. Sep 2001;145(3):506-7. [Medline].

  84. Sebastinei F. Esame dello stato della cuti individui affetti da neoplasmi maligni. Diagnosi. 1932;12:95-113.

  85. Sneddon IB, Roberts JB. An incomplete from of acanthosis nigricans. Gut. Sep 1962;3:269-72. [Medline].

  86. Stone OJ. The sign of Leser-Trelat: a cutaneous sign of internal malignancy: weakened subepithelial matrix from the effect of neoplasms on the extracellular matrix of the host. Med Hypotheses. Jun 1993;40(6):360-3. [Medline].

  87. Vielhauer V, Herzinger T, Korting HC. The sign of Leser-Trelat: a paraneoplastic cutaneous syndrome that facilitates early diagnosis of occult cancer. Eur J Med Res. Dec 29 2000;5(12):512-6. [Medline].

  88. Williams MG. Acanthoma appearing after eczema. Brit J Dermatol Syph. 1956;68:268-271.

  89. Yaniv R, Servadio Y, Feinstein A, Trau H. The sign of Leser-Trelat associated with transitional cell carcinoma of the urinary-bladder--a case report and short review. Clin Exp Dermatol. Mar 1994;19(2):142-5. [Medline].

Previous
Next
 
Middle-aged woman with a Christmas tree-like distribution of seborrheic keratoses on her back with no evidence of internal cancer.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.