The sign of Leser-Trélat in a case of adenocarcinoma of the lung

• Published in: Journal of the American Academy of Dermatology Vol. 43; no. 2; pp. 386 - 390
• Main Authors: Heaphy, Michael R., Millns, John L., Schroeter, Arnold L.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.08.2000; Elsevier
• Subjects: Acanthosis Nigricans - diagnosis; Acanthosis Nigricans - pathology; Adenocarcinoma - diagnosis; Adenocarcinoma - pathology; Biological and medical sciences; Biopsy; Female; Humans; Keratosis, Seborrheic - diagnosis; Keratosis, Seborrheic - pathology; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Medical sciences; Middle Aged; Paraneoplastic Syndromes - diagnosis; Paraneoplastic Syndromes - pathology; Pneumology; Skin - pathology; Tumor Necrosis Factor-alpha - analysis; Tumors of the respiratory system and mediastinum; Adenocarcinoma; Case study; Human; Skin disease; Association; Respiratory disease; Seborrheic keratosis; Malignant tumor; Bronchopulmonary
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/S0190-9622(00)70301-X

This is what we believe to be the first report of the sign of Leser-Trélat in association with occult adenocarcinoma of the lung. The sign of Leser-Trélat is proposed as a sign of possible occult malignancy, despite various suggestions to the contrary. Also, it is suggested that a tumor-produced humoral factor (eg, transforming growth factor-α [TGF-α]) could be responsible for both the acute eruption of the monomorphous seborrheic keratoses and the nearly concomitant development of acanthosis nigricans, which occurred in our case. The possible distinction between a hyperplastic and a neoplastic origin of various types of seborrheic keratosis is discussed in relation to this hypothetical humoral factor. In addition, we suggest a refinement of the definition of the sign of Leser-Trélat and discuss the use of “sign of Leser-Trélat” and “syndrome of Leser-Trélat” in relation to physical findings. All patients with the sign of Leser-Trélat should undergo a thorough evaluation for occult malignancy. (J Am Acad Dermatol 2000;43:386-90.)