A Case of the Sign of Leser-Trelat / 대한피부과학회지

ABSTRACT

The sign of Leser-Trelat refers to the sudden appearance and rapid increase in size and number of freckles and seborrheic keratoses, It is considered to be a sign of internal malignant tumors, most probable of the gastrointestinal tract. We report a case of adenocarcinoma of the stomach associated with the sign of Leser-Trelat and the literatures were reviewed. This 62-year-old man, over a period of 5 months, developed multiple seborrheic keratoses over his trunk and extremities. He came to our department in August 1981, because of sudden increse in their number and size during the several preceding months. He had never complained of the symptoms of gastrointestinal tract such as gastric pain, vomiting, indigestion, and weight loss. On examination of the skin, hundreds of brown or brown-black, more or less greasy verrucous papules were found almoat exclusively on the extensor aspects of forearms and lower legs. These lesions were variable in size and were consistent clinically with seborrheic keratoses. The findings of both fiberoptic biopsy and upper gastrointestinal tract series of roentgenographic studies were compatible with ulcer and adenocarcinoma of the stomach. Based on our experience, it is again suggested that though seborrheic keratoses are very common in the elderly, the rapid increase in size and number should arouse suspicion of an internal malignancy.