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The Pseudo-Sign of Leser-Trélat: A Rare Presentation

The true sign of Leser-Trélat is a rare cutaneous marker suggestive of an underlying malignancy. Its hallmark finding is the abrupt onset of multiple seborrheic keratoses (SKs) that increase rapidly in number and/or size within weeks to months. When the ominous finding is present, the associated tum...

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Autores principales: Suening, Barbara S, Neidenbach, Peter J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938783/
https://www.ncbi.nlm.nih.gov/pubmed/36819974
http://dx.doi.org/10.7759/cureus.35155
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author Suening, Barbara S
Neidenbach, Peter J
author_facet Suening, Barbara S
Neidenbach, Peter J
author_sort Suening, Barbara S
collection PubMed
description The true sign of Leser-Trélat is a rare cutaneous marker suggestive of an underlying malignancy. Its hallmark finding is the abrupt onset of multiple seborrheic keratoses (SKs) that increase rapidly in number and/or size within weeks to months. When the ominous finding is present, the associated tumor is usually aggressive and portends a poor prognosis. The “pseudo-sign” of Leser-Trélat also presents with the rapid onset of multiple SKs, but without any underlying disease. It is less well-known, and there are only a few reports documenting the phenomenon. This paper reports the case of an 89-year-old male who presented with multiple SKs that rapidly progressed over his scalp, neck, arms, back, trunk, and legs within two to three weeks. A clinical workup revealed elevated pancreatic tumor markers. His cancer antigen (CA) 19-9 levels were 52 U/mL (normal range 0-37 U/mL). Computed tomography (CT) of his abdomen/pelvis without intravenous (IV) and oral contrast showed no evidence of cancer. Bothersome SKs, such as those where his clothes were rubbed against, were destroyed via cryotherapy or shave removal under local anesthesia depending on their size. The patient has remained without any symptoms or findings of an underlying malignancy, confirming that his presentation was consistent with the pseudo-sign of Leser-Trélat. Because it can be concerning when a patient suddenly develops multiple large SKs, recognition of the pseudo-sign is important to determine the appropriate course of action.
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spelling pubmed-99387832023-02-19 The Pseudo-Sign of Leser-Trélat: A Rare Presentation Suening, Barbara S Neidenbach, Peter J Cureus Dermatology The true sign of Leser-Trélat is a rare cutaneous marker suggestive of an underlying malignancy. Its hallmark finding is the abrupt onset of multiple seborrheic keratoses (SKs) that increase rapidly in number and/or size within weeks to months. When the ominous finding is present, the associated tumor is usually aggressive and portends a poor prognosis. The “pseudo-sign” of Leser-Trélat also presents with the rapid onset of multiple SKs, but without any underlying disease. It is less well-known, and there are only a few reports documenting the phenomenon. This paper reports the case of an 89-year-old male who presented with multiple SKs that rapidly progressed over his scalp, neck, arms, back, trunk, and legs within two to three weeks. A clinical workup revealed elevated pancreatic tumor markers. His cancer antigen (CA) 19-9 levels were 52 U/mL (normal range 0-37 U/mL). Computed tomography (CT) of his abdomen/pelvis without intravenous (IV) and oral contrast showed no evidence of cancer. Bothersome SKs, such as those where his clothes were rubbed against, were destroyed via cryotherapy or shave removal under local anesthesia depending on their size. The patient has remained without any symptoms or findings of an underlying malignancy, confirming that his presentation was consistent with the pseudo-sign of Leser-Trélat. Because it can be concerning when a patient suddenly develops multiple large SKs, recognition of the pseudo-sign is important to determine the appropriate course of action. Cureus 2023-02-18 /pmc/articles/PMC9938783/ /pubmed/36819974 http://dx.doi.org/10.7759/cureus.35155 Text en Copyright © 2023, Suening et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Dermatology
Suening, Barbara S
Neidenbach, Peter J
The Pseudo-Sign of Leser-Trélat: A Rare Presentation
title The Pseudo-Sign of Leser-Trélat: A Rare Presentation
title_full The Pseudo-Sign of Leser-Trélat: A Rare Presentation
title_fullStr The Pseudo-Sign of Leser-Trélat: A Rare Presentation
title_full_unstemmed The Pseudo-Sign of Leser-Trélat: A Rare Presentation
title_short The Pseudo-Sign of Leser-Trélat: A Rare Presentation
title_sort pseudo-sign of leser-trélat: a rare presentation
topic Dermatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9938783/
https://www.ncbi.nlm.nih.gov/pubmed/36819974
http://dx.doi.org/10.7759/cureus.35155
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