REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES

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1.) Coexistence of acanthosis nigricans and the sign of Leser-Trelat in a patient with gastric adenocarcinoma: a case report and literature review.

2.) Sign of Leser-Trelat.

3.) Pancreatic carcinoma associated with the Leser-Trelat sign.

4.) Leser-Trelat sign with anaplastic ependymoma--an autopsy case.

5.) The sign of Leser-Trelat associated with esophageal carcinoma.

6.) Hereditary onset of multiple seborrheic keratoses: a variant of Leser Trelat sign?

7.) Cutaneous paraneoplastic syndromes in solid tumors.

8.) Benign Leydig cell tumor of the testis associated with human papillomavirus type 33 presenting with the sign of Leser-

9.) A case of pancreatic cancer with the sign of Leser-Trelat.

10.) 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.

11.) [Skin manifestation of internal malignancy].

12.) Leser-Trelat sign associated with Sezary syndrome.

13.) The sign of Leser-Trelat associated with transitional cell carcinoma of the urinary-bladder--a case report and short review.

14.) Mycosis fungoides with Leser-Trelat sign: the first report of a patient from Japan.

15.) The sign of Leser-Trelat associated with adenocarcinoma of the rectum.

16.)  Seborrheic keratoses and cancer.

17.) The sign of Leser-Trelat in a young woman with osteogenic sarcoma.

18.) Sign of Leser-Trelat with a metastatic mucinous adenocarcinoma.

19.) The sign of Leser-Trelat: does it exist? [see

20.) The sign of Leser-Trelat associated with malignant melanoma.

21.) Paraneoplastic rhinophyma and the Leser-Trelat sign.

22.) Transformation of lymphocytoma cutis into a malignant lymphoma in association with the sign of Leser-Trelat.

23.) Leser-Trelat sign associated with Sezary syndrome.

24.) The sign of Leser-Trelat associated with primary lymphoma of the brain.

25.) Acanthosis nigricans and the sign of Leser-Trelat associated with

adenocarcinoma of the gallbladder.

26.) Bile duct adenocarcinoma with Leser-Trelat sign and pure red blood cell aplasia.

27.) The sign of Leser-Trelat. Report of a case with adenocarcinoma of

the duodenum.

28.) [The Leser-Trelat symptom: report of two cases

29.) Adenocarcinoma of the stomach with eruptive seborrheic keratoses: the sign of Leserp-Trelat.

30.) Florid cutaneous papillomatosis, malignant acanthosis nigricans, and pulmonary squamous cell carcinoma.

31.) The relation between seborrheic keratoses and malignant solid tumours. A case-control study.

32.) Transformation of Sezary syndrome and the sign of Leser-Trelat: a histopathologic study.

33.) Sign of Leser-Trelat: report of two cases and review of the literature.

34.) Pemphigus foliaceus resembling eruptive seborrheic keratoses.

35.) Eruptive seborrheic keratoses in a young woman with acromegaly.

36.) Seborrheic keratosis and papillomatosis: markers of breast adenocarcinoma.

37.) A case of hepatocellular carcinoma with the sign of Leser-Trelat: a possible role of a cutaneous marker for internal malignancy.

38.) the relation between seborrheic keratoses and malignant solid tumours. A case-control study.

39.) [Useful cutaneous markers of internal malignancy in the early stage].

40.) [Gastrointestinal carcinoma with skin diseases from the standpoint of surgery].

41.) [Leser-Trelat sign in adenocarcinoma of the sigmoid colon--a rare clinical picture].

42.) [Acanthosis nigricans maligna and Leser-Trelat sign in double malignancy of the breast and stomach].

43.) Beitrage Zur Fruhdiagnose des darmcarcinoms (Hereditasverhaltnisse und Hautveranderungen)

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1.) Coexistence of acanthosis nigricans and the sign of Leser-Trelat in a patient with gastric adenocarcinoma: a case report and literature review.

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J Am Acad Dermatol 2000 Feb;42(2 Pt 2):357-62

Yeh JS, Munn SE, Plunkett TA, Harper PG, Hopster DJ, du Vivier AW

Department of Dermatology, King's College Hospital, London, United

Kingdom.

The association of acanthosis nigricans (AN) with the sign of

Leser-Trelat (LT) and gastric carcinoma is rare. Our patient was a69-year-old man, who presented with hematemesis; a stage-IV poorlydifferentiated, diffuse-type, adenocarcinoma of the gastric antrum was diagnosed.

The AN was striking, with florid cutaneous papillomatosisthat also involved the mucous membranes of the mouth and eyelids, and keratoderma. AN and the sign of LT predated tumor detection by 6 monthsand regressed after chemotherapy in parallel with reduction of the tumor load, demonstrating the dermatoses as paraneoplastic phenomena. Thepatient died 7 months after completion of chemotherapy. The coexistenceof AN and the sign of LT should prompt a search for underlying malignancy. The pathogenesis of both dermatoses is discussed.

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2.) Sign of Leser-Trelat.

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J Am Acad Dermatol 1996 Jul;35(1):88-95 Related Articles, Books, LinkOut

Schwartz RA

New Jersey Medical School, Newark 07103-2714, USA.

The sign of Leser-Trelat is rare. It is defined as the sudden eruptionof multiple seborrheic keratoses caused by a malignancy. Because bothseborrheic keratoses and cancer are common in the elderly, it is notalways easy to tell from the literature or in any given patient if thissign is present. In fact, its validity has been questioned. Itsassociation with malignant acanthosis nigricans is one of several of its features that support its legitimacy as a true paraneoplastic disorder.

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3.) Pancreatic carcinoma associated with the Leser-Trelat sign.

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Int J Pancreatol 1997 Oct;22(2):155-60 Related Articles, Books

Ohashi N, Hidaka N

Department of Surgery, Matsusaka Chuo Hospital, Mie, Japan.

A case of pancreatic carcinoma associated with the Leser-Trelat sign isreported. A 53-yr-old male had complained of mild epigastric discomfortand back pain accompanied by seborrheic keratoses, which had increasedin size and number over the previous 6 mo.

A tumor was detected in thehead of the pancreas and macroscopically curatively resected. His skin lesions diminished after surgery, but progressed again when the tumor recurred. Immunohistology for EGF showed a low level in the pancreaticcarcinoma cells but a higher EGF content was recognized in thehyperkeratinized portions of the seborrheic keratoses. Of 130 underlying malignancies described in the 125 reported patients with theLeser-Trelat sign, neoplasms of the gastrointestinal tract were mostcommon, comprising 47.7% of the total. The present case is the third case showing an association between a pancreatic carcinoma and theLeser-Trelat sign, but the first case for which the tumor of thepancreas was diagnosed in an early stage and resected surgically, as aresult of the suggestive nature of this sign.

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4.)Leser-Trelat sign with anaplastic ependymoma--an autopsy case.

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Acta Neuropathol (Berl) 1997 Jan;93(1):97-100 Related Articles, Books,

LinkOut

Hamada Y, Iwaki T, Muratani H, Imayama S, Fukui M, Tateishi J

Department of Neuropathology, Faculty of Medicine, Kyushu University,

Fukuoka, Japan.

A 36-year-old Japanese male, who 7 years previously had been diagnosed as having an ependymoma in the left parietal region, had receivedsurgery, chemotherapy and radiotherapy. He later developed a rapidgrowth of multiple skin lesions on his back and extremities, whichcoincided with a regrowth of the tumor. Postmortem examination revealedthat the ependymoma showed anaplastic transformation and necrosis;however, no malignancy was observed in the extracranial organs. The skin lesions were histologically diagnosed as seborrheic keratoses. We have,therefore, diagnosed the patient as having Leser-Trelat sign associatedwith anaplastic ependymoma.

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5.) The sign of Leser-Trelat associated with esophageal carcinoma.

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Am J Gastroenterol 1996 Apr;91(4):802-4 Related Articles, Books, LinkOut

Chiba T, Shitomi T, Nakano O, Shimotono H, Yamada H, Fujimaki E, Orii S,

Sato K, Sato S

First Department of Internal Medicine, School of Medicine, Iwate Medical

University, Morioka, Japan.

A 79-year-old woman was admitted to our hospital with complaints of dysphagia and multiple verrucous papules that had developed over theprevious year. The diagnosis of esophageal carcinoma was based on upper gastrointestinal radiography and endoscopic examination with biopsy. Theclinical syndrome was consistent with the sign of Leser-Trelatassociated with esophageal carcinoma. Although radiation therapy and chemotherapy were undertaken, the patient died 8 months later because ofthe sign of Leser-Trelat in association with squamous cell esophagealcarcinoma.

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6.) Hereditary onset of multiple seborrheic keratoses: a variant ofLeser Trelat sign?

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J Dermatol 1996 Mar;23(3):191-5 Related Articles, Books

Yamamoto T, Yokoyama A

Department of Dermatology, Tsuchiura Kyodo General Hospital, Ibaraki,

Japan.

A 79-year-old man in a cancer-prone family developed disseminated seborrheic keratoses over his trunk and extremities over a few decadeswithout rapid increase. His son, mother, and one of his brothers, whodied of gastric cancer, also had numerous seborrheic keratoses for a long time. He had a biliary tract cancer. Histologic examination showedhyperproliferation of basaloid cells branching downwards, as if inducedby surrounding stroma. No decrease of the number of seborrheic keratosesafter surgical operation has been observed. Examination for thelocalization of epidermal growth factor receptor (EGF-R) and HER-2/neu oncoprotein by immunohistochemistry revealed positive staining on theepithelial strands branching downwards on the specimens of seborrheic keratoses. A different pattern of expression was demonstrated in normalseborrheic keratosis. These findings suggest that some unidentifiedgrowth factors may be involved in the induction of visceral and/orcutaneous neoplasms in this family.

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7.) Cutaneous paraneoplastic syndromes in solid tumors. ===========================================================

Am J Med 1995 Dec;99(6):662-71 Related Articles, Books

Kurzrock R, Cohen PR

Department of Clinical Investigation, University of Texas M.D. AndersonCancer Center, Houston 77030, USA.

OBJECTIVE:

To provide an overview of the clinical manifestations, pathophysiology, and oncologic implications of the cutaneousparaneoplastic syndromes that occur predominantly in patients with solidtumors. METHODS: A review was performed of the literature identified bya comprehensive MEDLINE search.

RESULTS:

Diverse cutaneousparaneoplastic syndromes may be associated with underlying tumors. They include musculoskeletal disorders (clubbing, hypertrophicosteoarthropathy, dermatomyositis, and multicentricreticulohistiocytosis), reactive erythemas (erythema gyratum repens andnecrolytic migratory erythema), vascular dermatoses (Trousseau's syndrome), papulosquamous disorders (acanthosis nigricans, tripe palms,palmar hyperkeratosis, acquired ichthyosis, pityriasis rotunda, Bazex's syndrome, florid cutaneous papillomatosis, the sign of Leser-Trelat, andextramammary Paget's disease), and disorders of hair growth(hypertrichosis lanuginosa acquisita). The clinical manifestations ofthese dermatoses may precede, coincide with, or follow the diagnosis ofcancer. The presence of a cutaneous paraneoplastic syndrome is oftenassociated with a poor prognosis.

CONCLUSIONS: Cutaneous paraneoplastic syndromes are specific constellations of mucous membrane and/or skinabnormalities that are caused by an underlying tumor. Since they may bethe presenting sign of an occult cancer, cognizance of their featuresand clinical implications are of considerable importance. Individualswith these syndromes should have a thorough workup for an associatedmalignancy.

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8.) Benign Leydig cell tumor of the testis associated with humanpapillomavirus type 33 presenting with the sign of Leser-===========================================================

Trelat.

J Urol 1993 Oct;150(4):1246-50 Related Articles, Books

Martin RW 3d, Rady P, Arany I, Tyring SK

Department of Dermatology, Johns Hopkins School of Medicine, Baltimore,Maryland.

We present a case of a benign testicular Leydig cell tumor and eruptive seborrheic keratosis associated with human papillomavirus type 33infection. To our knowledge this is the first occurrence of a Leydigcell tumor in a patient with tuberous sclerosis and the second documented case of eruptive seborrheic keratoses (sign of Leser-Trelat)associated with a benign neoplasm.

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9.) A case of pancreatic cancer with the sign of Leser-Trelat.

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Nippon Geka Hokan 1993 Jul 1;62(4):203-8 Related Articles, Books

Hirano T, Yoshioka H, Manabe T

Department of Surgery, Yoshioka Hospital, Kyoto, Japan.

A case of 79-year-old man with pancreatic cancer associated with thesign of Leser-Trelat was presented. Abdominal CT scanning was performedand a pancreatic tail tumor involving the spleen and the greater omentumas well as ascitic retention were detected. Ba-enema study showed thestenosis of the sigmoid colon, suggesting the peritoneal disseminations.Absolute non-curative operation of side-to-side transverso-sigmoidostomy was performed for colonic stenosis, and biopsy of the disseminatedomental tumor was performed, which was histologically diagnosed as welldifferentiated papillary adenocarcinoma compatible with pancreatic cancer. The postoperative course was uneventful and at present thepatient was followed at outpatient clinic. To our knowledge, this caseis the first report with pancreatic cancer associated with the sign ofLeser-Trelat in Japan.

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10.) The sign of Leser-Trelat: a cutaneous sign of internal malignancy:weakened subepithelial matrix from the effect of neoplasms on theextracellular matrix of the host.

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Med Hypotheses 1993 Jun;40(6):360-3

Stone OJ

The sudden onset of many seborrheic keratoses (SK) associated with an internal malignancy (most commonly adenocarcinoma) is called the sign ofLeser-Trelat. It is associated with acanthosis nigricans (AN) in 20% ofthe cases. There are marked changes in the extracellular matrix (ECM)around tumors. Various fractions and depolymerized glycosaminoglycansenter circulation. They can incorporate in the general extracellular matrix. Mechanical factors present in AN produce extrusions of this poorquality ECM in the form of papillae and folds. The poor quality of subepithelial extracellular matrix produces the marked epithelialchanges of acanthosis nigricans which shows hyperkeratosis,papillomatosis, slight irregular acanthosis, and keratin material formation. The neoplasm can produce the same qualitative changes in thesubepithelial ECM on otherwise normal appearing skin. When the alteredsame epithelial changes occur on this biologically altered skin the result is many SK (the sign of Leser-Trelat).

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11.) [Skin manifestation of internal malignancy].

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Gan To Kagaku Ryoho 1991 Mar;18(3):365-70 Related Articles, Books

Nishiyama S

Department of Dermatology, School of Medicine, Kitasato University,

Sagamihara, Japan.

Relationship between malignant tumor of the internal organ and the skincan be classified as skin metastasis of the malignant tumor,non-specific skin manifestation of the malignant tumor and hereditarysyndrome which tends to have malignant tumor. I, however, discuss here

mainly about the non-specific manifestation of the malignant tumor byshowing representative cases of the dermadrome. Such cases areacanthosis nigricans, Leser-Trelat's sign, dermatomyositis, atypical erythema, acquired ichthyosis, Sweet's disease, Weber-Christian'ssyndrome, phlebitis migrans and Bazex syndrome.

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12.) Leser-Trelat sign associated with Sezary syndrome.

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SO  - J Dermatol  1995 Jan;22(1):62-7

AU  - Ikari Y; Ohkura M; Morita M; Seki K; Kubota Y; Mizoguchi M

 

PT  - JOURNAL ARTICLEAB 

- A 74-year-old Japanese male had developed generalized erythrodermaand rapid growth of multiple verrucous lesions over the entire surfaceof his face, trunk, and extremities three months before he was seen. Histologically seborrheic keratoses were revealed. Laboratoryexaminations showed peripheral leukocytosis with atypical lymphocytesand high levels of IgE and IgG. On the basis of these clinical andhistopathologic findings, we diagnosed the patient as havingLeser-Trelat sign associated with Sezary syndrome. The erythrodermasubsided after administration of oral predonisone, and no new formationsof seborrheic keratosis were observed. However, because of subsequentaggravation of the generalized erythroderma, we administered chemotherapy. Six months after the initial examination, lung cancer wasfound, and the patient subsequently died of respiratory and renalfailure.

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13.) The sign of Leser-Trelat associated with transitional cellcarcinoma of the urinary-bladder--a case report and short review.

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SO  - Clin Exp Dermatol  1994 Mar;19(2):142-5

AU  - Yaniv R; Servadio Y; Feinstein A; Trau H

PT  - JOURNAL ARTICLE; REVIEW (28 references);

 REVIEW OF REPORTED CASES

AB  - Leser-Trelat sign is defined as the sudden appearance of multipleseborrhoeic keratoses in association with internal malignancy. Although75 cases have been reported to date, controversy still exists about thesignificance of this sign. The first association of the Leser-Trelatsign with transitional cell carcinoma of the urinary-bladder isreported. 

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14.) Mycosis fungoides with Leser-Trelat sign: the first report of apatient from Japan.

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SO  - J Dermatol  1994 Mar;21(3):189-93

AU  - Miyako F; Dekio S; Tamura H; Yamada Y; Miyata N; Jidoi J; Tohgi KPT  - JOURNAL ARTICLEAB  -

 We describe here a 35-year-old Japanese woman with mycosisfungoides (MF) who developed numerous, rapidly-growing, seborrheic keratoses on the front of her neck and chest. To the best of ourknowledge, this is the first reported case of MF with Leser-Trelat signfrom Japan.

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15.) The sign of Leser-Trelat associated with adenocarcinoma of the rectum.

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SO  - Cutis  1993 Apr;51(4):255-7

AU  - Cohn MS; Classen RF

PT  - JOURNAL ARTICLE

AB  - The authors report a case of the sign of Leser-Trelat occurring ina patient with primary adenocarcinoma of the rectum. The patient demonstrated the sign several months before the internal malignancy wasdiscovered. Although the majority of patients with the sign have anunderlying adenocarcinoma of the gastrointestinal tract, relatively fewcases have been reported with the rectum as the primary site. This casedemonstrates a classic example of the sign of Leser-Trelat andillustrates its importance as a marker of underlying malignancy. ===========================================================

16.)  Seborrheic keratoses and cancer.

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SO  - J Am Acad Dermatol  1992 Jun;26(6):947-50

AU  - Lindelof B; Sigurgeirsson B; Melander S

PT  - JOURNAL ARTICLE

AB  - BACKGROUND:

 The eruptive appearance of numerous seborrheickeratoses, the sign of Leser-Trelat, has been regarded as a reliable cutaneous marker of internal malignancy.

OBJECTIVE:

We have evaluatedthe possible association of malignant disease and the sign in 1752consecutive cases of seborrheic keratoses.

METHODS:

First, the SwedishCancer Registry was searched for records of malignancies in the studypopulation (1958 to 1984), and the expected number of malignancies was calculated. Second, records of persons with malignancy within 1 yearbefore or after the diagnosis of seborrheic keratosis were checked forthe sign of Leser-Trelat. Third, a case control study was performed toevaluate the possibility of eruptive seborrheic keratoses among thenoncancer patients in the study population.

RESULTS:

The results showeda slight increased risk of cancer in the study population (relative risk= 1.2; 95% confidence interval = 1.0 to 1.3), mainly because of anincreased risk of cutaneous squamous cell carcinoma. In 62 patients with seborrheic keratoses, a malignancy (excluding skin) was diagnosed within1 year before or after the diagnosis of seborrheic keratosis. Of these62 patients, 6 were regarded as possibly having presented with the signof Leser-Trelat. For every one of the 62 cases with seborrheic keratosisand malignancy within one year, an age- and sex-matched control patient without cancer was selected from the study population and the recordswere checked for sudden and eruptive seborrheic keratoses. Among thecontrol patients, five were regarded as possibly having presented withthe sign of Leser-Trelat.

CONCLUSION: This study gives no evidence tosupport the opinion that eruptive seborrheic keratoses are related to internal cancer risk.

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17.) The sign of Leser-Trelat in a young woman with

osteogenic sarcoma.

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SO  - J Am Acad Dermatol  1992 Feb;26(2 Pt 2):344-7

AU  - Barron LA; Prendiville JS

PT  - JOURNAL ARTICLE

AB  - The sign of Leser-Trelat refers to a sudden increase in size and number of seborrheic keratoses associated with internal malignancy. Thevalidity of this cutaneous sign continues to be debated, particularlybecause of the prevalence of both seborrheic keratoses and malignancy inthe elderly population. Preceding inflammatory skin conditions are knownto precipitate eruptions of seborrheic keratoses in otherwise healthy persons. These cutaneous lesions may also be associated with othermarkers of underlying malignancy such as acanthosis nigricans. Wepresent a young female patient with osteogenic sarcoma in whom eruptive seborrheic keratoses developed. We believe this case is representativeof the sign of Leser-Trelat.

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18.) Sign of Leser-Trelat with a metastatic mucinous adenocarcinoma.

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SO  - Cutis  1991 Apr;47(4):258-60

AU  - Schwartz RA; Helmold ME; Janniger CK; Gascon P

PT  - JOURNAL ARTICLE

AB  - We describe a middle-aged woman with the sudden onset of multiple seborrheic keratoses in association with a metastatic mucinousadenocarcinoma to the liver from an unknown primary neoplasm. This caseillustrates the significance of the sign of Leser-Trelat and its association with cancer.

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19.) The sign of Leser-Trelat: does it exist? [see

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comments]SO  - J Am Acad Dermatol  1989 Jul;21(1):50-5AU  - Rampen HJ; Schwengle LEPT  - JOURNAL ARTICLE; REVIEW (51 references);

 REVIEW OF REPORTED CASESAB  - The sign of Leser-Trelat is usually regarded as a reliable cutaneous marker of internal malignancy. We have reviewed the literatureand conclude that the evidence for a causal relation between eruptive seborrheic keratoses and cancer is meager.

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20.) The sign of Leser-Trelat associated with malignant melanoma.

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SO  - Cutis  1989 Jul;44(1):39-41

AU  - Fanti PA; Metri M; Patrizi A

PT  - JOURNAL ARTICLEAB  -

A case of the sudden appearance of multiple pruritic seborrheickeratoses (Leser-Trelat sign) associated with cutaneous malignant melanoma is reported. To the authors' knowledge, this association hasnot been previously reported.

 

=========================================================== 21.) Paraneoplastic rhinophyma and the Leser-Trelat sign. ===========================================================

SO  - Clin Exp Dermatol  1989 May;14(3):253-5AU  - Mayou SC; Benn JJ; Sonksen PH; Black MMPT  -

 JOURNAL ARTICLE

 AB  - A case of the Leser-Trelat sign associated with an underlyingmalignant haemangiopericytoma is described. In addition, the patient hadprofound hypoglycaemia and a rhinophyma-like nasal swelling which rapidly resolved post-operatively.

The tumour appeared to be secreting afactor(s) which cross-reacted with both insulin receptors to induce hypoglycaemia and epidermal growth factor receptors inducing a profusionof eruptive seborrhoeic warts. It aslo had marked sebotrophic activity.The association of the Leser-Trelat sign with malignant haemangiopericytoma has not previously been described.

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22.) Transformation of lymphocytoma cutis into a malignant lymphoma inassociation with the sign of Leser-Trelat.

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SO  - Acta Derm Venereol  1987;67(2):172-5

AU  - Halevy S; Sandbank MPT  - JOURNAL ARTICLEAB  - A patient is described in whom transformation of lymphocytomacutis (LC) into malignant lymphoma, diffuse, mixed small and large lymphocytes, occurred in association with the sign of Leser-Trelat (LT),which is a marker for internal malignancy. To the best of our knowledge,such an association has not been reported previously.

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23.) Leser-Trelat sign associated with Sezary syndrome.

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SO  - Cutis  1985 Nov;36(5):409-10

AU  - Horiuchi Y; Katsuoka K; Tsukamoto K; Takezaki SPT  - JOURNAL ARTICLEAB  - The Leser-Trelat sign is a rare but well known cutaneous indicatorof internal malignancy, most commonly adenocarcinoma of the stomach.There have been only a few cases associated with lymphoproliferativemalignancies. Sezary syndrome is a chronic leukemia/lymphoma characterized by generalized erythroderma and circulating Sezary cells.We describe a rare case of the Leser-Trelat sign associated with theSezary syndrome. The skin sign was alleviated through combinationchemotherapy.

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24.) The sign of Leser-Trelat associated with primary lymphoma of thebrain.

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SO  - Cutis  1984 Aug;34(2):164-5

AU  - Kaplan DL; Jegasothy B

PT  - JOURNAL ARTICLE

AB  - The sign of Leser-Trelat has been defined as the sudden appearanceof seborrheic keratoses in number and/or size in association with anunderlying malignancy. There have been only thirty-two reported cases ofthe sign of Leser-Trelat since it was first described in 1984. This isthe first known case of primary lymphoma of the brain associated withthis sign. Until Dantzig's review of the literature in 1973, the onlytumor type associated with this sign had been adenocarcinomas of thegastrointestinal tract and the genitourinary tract. Since that timethere have been only nine cases reported that were not adenocarcinomas;of those, only four cases have been lymphoproliferative malignancies. Wewish to emphasize the need for further reports of this sign to bettercharacterize it and to make physicians more aware of the associationbetween this dermatologic sign and an internal malignancy.

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25.) Acanthosis nigricans and the sign of Leser-Trelat associated withadenocarcinoma of the gallbladder.

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SO  - Cancer  1981 Jul 15;48(2):325-8

AU  - Jacobs MI; Rigel DS

PT  - JOURNAL ARTICLE

AB  - A case of adenocarcinoma of the gallbladder associated withacanthosis nigricans and the sign of Leser-Trelat is presented. The significant underrepresentation of adenocarcinoma of the gallbladder inassociation with malignant acanthosis nigricans is noted. If malignantacanthosis nigricans is caused by an ectopic peptide, a relative lack ofproduction of the postulated substance by gallbladder adenocarcinomacells could account for this finding.

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26.) Bile duct adenocarcinoma with Leser-Trelat sign and pure red bloodcell aplasia.

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SO  - Cancer  1980 Oct 1;46(7):1657-60

AU  - Lee CH; Clark AR; Thorpe ME; Mackie BS; Firkin FC

PT  - JOURNAL ARTICLE

AB  - A case of adenocarcinoma of the bile duct complicating longstanding ulcerative colitis and associated with the rapid onset andgrowth of multiple seborrheic keratosis (Leser-Trelat sign) and pure redblood cell aplasia is described. This is the first report of a case ofthe coexistence of the Leser-Trelat sign and pure red blood cell aplasiain a patient with a malignancy. Both manifestations have been doubted as truly paraneoplastic manifestations because of their rarity in clinicalmedicine. Their co-existence in the present case would support theirassociaton with malignancy.

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27.) The sign of Leser-Trelat. Report of a case with adenocarcinoma ofthe duodenum.

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SO  - Arch Dermatol  1980 Sep;116(9):1059-60

AU  - Curry SS; King LE

PT  - JOURNAL ARTICLE

AB  - The sign of Leser-Trelat is a rare cutaneous manifestation of internal malignancy. Although adenocarcinoma is the most commonmalignant neoplasm associated with the sign of Leser-Trelat, we reportwhat we believe to be the first case of adenocarcinoma of the duodenum associated with this sign. Because of the location of the tumor, weconsidered the possibility that the skin changes may be due to increasedlevels of epidermal growth factor (EGF) in this patient. However, noalteration in urine EGF levels was found.

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28.) [The Leser-Trelat symptom: report of two cases

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(author's transl)]

SO  - Ann Dermatol Venereol  1980;107(11):1035-41

AU  - Lambert D; Fort M; Legoux A; Chapuis JL

MC  - English AbstractPT  -

JOURNAL ARTICLE; REVIEW (22 references)

AB  - The sudden occurrence and rapid increase in size and number ofseborrheic keratoses is considered to be a symptom of internal malignancy. But many authors did not fully agree with this finding. Wereport two cases respectively associated, the first with a mycosisfongoides, the second with a bronchial squamous cell carcinoma. These

observations are compared with thin cases previously published in thedermatological literature (13 patients). According to Dantzig thecommonest associated malignancy is an adenocarcinoma, and the most frequent site the stomach. But there are also report of acute leukemia,mycosis fongoides, Sezary and lymphocytic lymphoma. The mechanism of the simultaneous growth of the lesions remains unknown and may be purelycoincidental. Other case reports and several criteria still to bedefined are needed before we accept this symptom as a malignancy marker.

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29.) Adenocarcinoma of the stomach with eruptive seborrheic keratoses:the sign of Leserp-Trelat.

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SO  - Cancer  1980 May 1;45(9):2434-7

AU  - Sperry K; Wall J

PT  - JOURNAL ARTICLE

AB  - The sign of Leser-Trelat, the sudden appearance of multipleseborrheic keratoses in conjunction with an internal malignancy, is very uncommon. A case involving a patient who had undergone resection of anadenocarcinoma of the sigmoid colon followed ten years later by thedevelopment of an adenocarcinoma of the stomach with exhibition of the sign of Leser-Trelat is presented. A summary of reported cases, alongwith a discussion of the sign, is provided. This is the first reportedcase of a patient presenting with the sign of Leser-Trelat along with asecond primary malignancy.

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30.) Florid cutaneous papillomatosis, malignant acanthosis nigricans,and pulmonary squamous cell carcinoma.

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SO  - Int J Dermatol  1991 Mar;30(3):193-7

AU  - Gheeraert P; Goens J; Schwartz RA; Lambert WC; Schroeder F;

Debusscher L

PT  - JOURNAL ARTICLE; REVIEW (25 references);

 REVIEW OF REPORTED CASES

AB  - A 72-year-old man had florid cutaneous papillomatosis (FCP), whichis an obligatory paraneoplastic syndrome always associated with aninternal malignancy. The cancer, which is usually intraabdominal andmost often gastric in origin, evolves parallel to the FCP. This patientis the first case of FCP occurring in association with a lungmalignancy. An association of FCP with other signs of internal cancer iscommon, with malignant acanthosis nigricans usually appearing many times with the sign of Leser-Trelat. FCP, malignant acanthosis nigricans, andthe sign of Leser-Trelat are part of a continuum, developing by a commonor similar pathogenic pathway due to an underlying malignancy producinga factor possibly similar to human epidermal growth factor.

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31.) The relation between seborrheic keratoses and malignant solidtumours. A case-control study.

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SO  - Acta Derm Venereol  1991;71(2):166-9

AU  - Grob JJ; Rava MC; Gouvernet J; Fuentes P; Piana L; Gamerre M;Sarles JC; Bonerandi JJPT  -

 JOURNAL ARTICLE

AB  - In order to establish whether or not here is an associationbetween cancer and intense growth of seborrheic keratosis, the so-calledLeser-Trelat sign, we conducted a case control study in which the numberand features of seborrheic keratosis in 82 patients with recent solid

tumours, were compared with 82 age- and sex-matched controls. Neithernumbers nor features of seborrheic keratosis differed significantly inpatients and controls. Eruptive seborrheic keratosis was noted in onlyone patient and one control. This study showed that solid malignanciesare not generally associated with an increase in the number or size ofseborrheic keratosis lesions, thus suggesting that they are not controlled by a hypothetical secretion of growth factors by tumours. Ourresults suggest that Leser-Trelat is either a coincidence, or at most avery rare sign of unusual types of cancer. We also showed that multiple cherry angiomas, previously reported to be a paraneoplastic sign, arenot regularly associated with solid tumours.

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32.) Transformation of Sezary syndrome and the sign of Leser-Trelat: ahistopathologic study.

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SO  - J Am Acad Dermatol  1990 Sep;23(3 Pt 1):520-2

AU  - Wieselthier JS; Bhawan J; Koh HK

PT  - JOURNAL ARTICLE

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33.) Sign of Leser-Trelat: report of two cases and review of the

literature.

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SO  - J Am Acad Dermatol  1984 Jan;10(1):83-8

AU  - Venencie PY; Perry HO

PT  - JOURNAL ARTICLE

AB  - The sudden appearance of multiple seborrheic keratoses in the two

patients could be related to adenocarcinoma of the breast. Despite other

isolated reports, this disorder is still controversial as a marker of

malignancy.

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34.) Pemphigus foliaceus resembling eruptive seborrheic keratoses.

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SO  - Arch Dermatol  1980 Jul;116(7):815-6

AU  - Bruckner N; Katz RA; Hood AF

PT  - JOURNAL ARTICLEAB  - A 78-year-old man had an acute eruption of lesions that clinically resembled seborrheic keratoses. Microscopic examination of the lesionsindicated acantholysis and dyskeratosis primarily in the granular layer.The patient's serum contained antibodies to intercellular substance.Direct immunofluorescence microscopy of a lesion demonstratedimmunoglobulin deposition in the intercellular areas. Treatment withoral prednisone produced rapid resolution of the lesions. Patients in whom eruptive seborrheic keratoses (Leser-Trelat sign) develop shouldhave histological examination of their lesions to rule out the diagnosisof pemphigus foliaceus.

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35.) Eruptive seborrheic keratoses in a young woman with acromegaly.

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SO  - J Am Acad Dermatol  1990 Nov;23(5 Pt 2):991-4

AU  - Kilmer SL; Berman B; Morhenn VB

PT  - JOURNAL ARTICLE

AB  - The sign of Leser-Trelat, or eruptive seborrheic keratoses, is purported to be a cutaneous marker for many underlying malignancies.Elevation in levels of growth factors has been postulated to be the stimulus for the sudden eruption of multiple new seborrheic keratoses.In support of this hypothesis we present a case of eruptive seborrheickeratoses in a young woman with acromegaly and elevated levels of growthhormone.

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36.) Seborrheic keratosis and papillomatosis: markers of breastadenocarcinoma.

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SO  - Cutis  1983 Aug;32(2):161-2

AU  - Friedman-Birnbaum R; Haim S

PT  - JOURNAL ARTICLEAB  -

Seborrheic keratosis (Leser-Trelat sign) and extensive florid papillomatosis of the skin and the mucous membranes of the nose, mouth,throat, and external genitalia were associated with adenocarcinoma ofthe breast in a 61-year-old woman.

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37.) A case of hepatocellular carcinoma with the sign of Leser-Trelat: apossible role of a cutaneous marker for internal malignancy.

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Jpn J Med 1991 Jan-Feb;30(1):53-6 Related Articles, Books, LinkOut

Tajima H, Mitsuoka S, Ohtsuka E, Nakamura Y, Nakayama T, Satoh Y, Shima M, Nakata K, Kusumoto Y, Koji T, et al

First Department of Internal Medicine, Nagasaki University School of

Medicine, Japan.

A rare case of hepatocellular carcinoma who developed the complication of the sign of Leser-Trelat is reported. The patient, a 57-year-oldmale, visited our hospital with complaints of generalized malaise andanorexia. A diagnosis of hepatocellular carcinoma was made based onelevated alpha-fetoprotein measurement, ultrasonography, and hepaticarteriography findings. Chest x-ray film suggested pulmonary metastasesof hepatocellular carcinoma. Thereafter, complications of the seborrheickeratosis developed in the trunk and the skin lesion was diagnosed asthe sign of Leser-Trelat associated with hepatocellular carcinoma. Thepatient died of pneumonia 9 months after development of the sign ofLeser-Trelat.

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38.) the relation between seborrheic keratoses and malignant solidtumours. A case-control study.

===========================================================

Acta Derm Venereol 1991;71(2):166-9 Related Articles, Books

Grob JJ, Rava MC, Gouvernet J, Fuentes P, Piana L, Gamerre M, Sarles JC,

Bonerandi JJ

Service de Dermatologie, Hopital Ste Marguerite, Marseille, France.

In order to establish whether or not here is an association between cancer and intense growth of seborrheic keratosis, the so-calledLeser-Trelat sign, we conducted a case control study in which the numberand features of seborrheic keratosis in 82 patients with recent solid tumours, were compared with 82 age- and sex-matched controls. Neithernumbers nor features of seborrheic keratosis differed significantly inpatients and controls. Eruptive seborrheic keratosis was noted in onlyone patient and one control.

This study showed that solid malignanciesare not generally associated with an increase in the number or size ofseborrheic keratosis lesions, thus suggesting that they are not controlled by a hypothetical secretion of growth factors by tumours. Ourresults suggest that Leser-Trelat is either a coincidence, or at most avery rare sign of unusual types of cancer. We also showed that multiple cherry angiomas, previously reported to be a paraneoplastic sign, arenot regularly associated with solid tumours.

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39.) [Useful cutaneous markers of internal malignancy in the earlystage].

===========================================================

Gan To Kagaku Ryoho 1988 Apr;15(4 Pt 2-3):1564-8 Related Articles, Books

Mori S

Dept. of Dermatology, Gifu University School of Medicine.

Numerous skin changes are correlated with internal malignancy. These skin changes are collectively called dermadromes of internal malignancyor syndroma dermato-tumorale. The skin markers of internal malignancycan be classified into

1) skin metastasis,

2) paraneoplastic dermatoses,

3) cutaneous manifestations of the systemic carcinogenic disease processand

4) cancer-malformation syndrome.

For diagnosis of the early stage ofinternal malignancy, paraneoplastic dermatoses are the most importantamong other skin changes. Above all, dermatomyositis, figurate erythemas, erythroderma and a number of bullous dermatoses (e.g.,bullous pemphigoid, pemphigus vulgaris and dermatitis herpetiformis,Sweet' syndrome, pruritus, prurigo, acanthosis nigricans, Leser-Trelatsign, alopecia mucinosa, acquired ichthyosis, Bazex' syndrome,hypertrichosis aquisita lanuginosa) are among the paraneoplasticdermatoses.

 A total of 405 cases of syndroma dermato-tumorale except cases of skin metastasis were reported for recent 7 years (1980-1986)only in the dermatological field in Japan. Among them, cases ofparaneoplastic dermatoses number 354 accounting for the majority. Finally, brief consideration is given to the relationship between theabove mentioned skin manifestations and internal malignancy.

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40.) [Gastrointestinal carcinoma with skin diseases from the standpointof surgery].

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Gan To Kagaku Ryoho 1988 Apr;15(4 Pt 2-3):1560-3 Related Articles, Books

Nishidoi H, Koga S, Kanbe N

1st Dept. of Surgery, Tottori University School of Medicine.

We encountered 21 patients with gastrointestinal carcinoma accompanied with skin diseases such as acanthosis nigricans, dermatomyositis,pemphigoid, erythrodermia, ichthyosis vulgaris, herpes zoster,Leser-Trelat's sign, Recklinghausen's disease and Gardner's syndrome. Wehave discussed such cases from the standpoint of surgery. There were 16cases (76%) with gastric carcinoma, which were almost in the faradvanced stage. Carcinomas of the other patients were seen in the esophagus, liver, pancreas, small intestine and rectum. Although skinlesions appeared before the onset of gastrointestinal symptoms in almostall cases, detection of carcinomas was very difficult until the symptomsemerged. In 6 of 21 patients (29%), carcinomas were detected by onlyskin manifestation, and they proved to be gastric cancer in all cases. Although the relationship of gastrointestinal carcinoma and skindiseases was unclear, we presented a 70-year-old woman with acanthosisnigricans accompanied with gastric cancer, whose skin manifestation wasreduced by the therapy for gastric cancer. Therefore, some of these skinmanifestation may be a symptom of the biological characteristics of thegastrointestinal carcinoma.

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41.) [Leser-Trelat sign in adenocarcinoma of the sigmoid colon--a rareclinical picture].

===========================================================

Z Hautkr 1987 Jun 1;62(11):875-6 Related Articles, Books

Hodak E, Halevy S, Ingber A, Engelstein D, Sandbank M

We report on a 75-year-old man showing the very rare association of Leser-Trelat's sign and adenocarcinoma of the sigmoid colon. Our case isthe second one reported so far.

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42.) [Acanthosis nigricans maligna and Leser-Trelat sign in doublemalignancy of the breast and stomach].

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Z Hautkr 1987 Mar 1;62(5):344-66 Related Articles, Books

Stieler W, Plewig G

A female patient with primary cancer of the breast and the stomach developed acanthosis nigricans maligna and Leser-Trelat's sign.Acanthosis nigricans maligna is a well-known cutaneous marker ofinternal malignancy. It may be intensified by radiotherapy. A variant is called florid cutaneous papillomatosis. Leser-Trelat's sign is a rarecutaneous marker of internal neoplasms. According to the literature, wepresent 46 patients showing Leser-Trelat's sign. Neither Leser norTrelat described this sign.

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43.) Beitrage Zur Fruhdiagnose des darmcarcinoms (Hereditasverhaltnisse und Hautveranderungen) hollander E

Dtsch Med Woschenschr 1900;26:483-5

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DATA-MÉDICOS/DERMAGIC-EXPRESS No 2-(92)  05/03/2000 DR. JOSÉ LAPENTA R. 

UPDATED 05 AUGUST 2025

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Produced by Dr. José Lapenta R. Dermatologist

Venezuela 1.998-2.025

Producido por Dr. José Lapenta R. Dermatólogo Venezuela 1.998-2.025

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