Sign of Leser-Trelat Workup

Updated: Apr 05, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Workup

Laboratory Studies

Laboratory abnormalities are due to the associated malignancy. Appropriate clinical tests should be performed, depending on the clinical setting. The author recommends the following:

  • Routine blood and chemistry studies, including a complete blood cell count with differential and absolute platelet counts

  • Examination of the stool for occult blood

  • Carcinoembryonic antigen test

  • Urinalysis with cytologic examination

  • Papanicolaou test in women

  • Cervical cytologic examination in women

  • Prostate-specific antigen testing in men

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Imaging Studies

The following should be performed:

  • Chest radiography

  • Mammography in women

  • Upper and lower gastrointestinal radiographic studies

CT scanning of the abdomen and the pelvis should be considered.

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Procedures

The author recommends that a biopsy specimen be obtained to confirm the diagnosis. Complete colorectal and gastric endoscopic examinations should also be performed if no malignancy is detected.

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Histologic Findings

In this syndrome, seborrheic keratoses are the same as the common type of seborrheic keratosis. Both types involve epidermal hyperkeratosis, papillomatosis, and acanthosis with cystic inclusion of keratinous material (eg, horn pseudocysts). Variants, such as adenoid-type seborrheic keratoses, have not yet been described.

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