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129. the sign of leser-trélat

A cutaneous marker of internal malignancy described in the 19th century by two surgeons, Edmund Leser (German) and Ulysse Trélat(French). This sign refers to the sudden appearance and rapid increase in size and number of seborrheic keratoses on skin that was previously blemish-free. Inmost of the reported cases, adenocarcinoma has been the commonest tissue type, while the gastrointestinal tract has been the commonest site of origin. Othertissue types have included leukemias, lymphomas, sarcomas, and squamous cell carcinomas.

The seborrheic keratoses may precede, accompany, or follow detection of the primary tumor and may regress or disappear when theprimary tumor is treated. Why these keratoses appear remains speculative.

In the patient shown, squamous cell carcinoma of the lung was the primary tumor. Note the thoracotomy scar beneath the leftscapula.

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Source:  OpenStax, Images of memorable cases: 50 years at the bedside. OpenStax CNX. Dec 08, 2008 Download for free at http://cnx.org/content/col10449/1.7
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