Causes and risk factors
The exact cause of Leser-Trelat sign is not known. It is commonly associated with malignant acanthosis nigricans, adenocarcinoma of the stomach or colon, squamous cell carcinoma, lymphoma, leukemia. Role of human papilloma virus is considered important, especially in immunocompromised patients for development of the disease.
Clinical presentation
Disease occurs commonly in elderly people. Pruritus is the only symptom produced. Patient presents with brown colored, warty nodules. Face, neck, axillae, groin, and the extremities are affected. Sudden eruption of seborrheic keratoses, accompanying symptoms of acanthosis nigricans such as dark colored patches in the areas such as armpits, groin, neck region, umbilicus, and forehead are seen. The skin is thickened and it may smell bad.
Investigations
Medical history by the patient and clinical examination by the dermatologist helps in diagnosis. Leser-Trelat sign is suspected when there is a sudden increase in size and number of seborrheic keratoses over a short period of time. Skin biopsy confirms the diagnosis.
Treatment
No treatment is required for Leser-Trelat sign. Treatment of underlying cancer is essential. Surgery may be helpful to remove the lesions.
Complications
Complications such as metastasis of the cancer may occur.
When to Contact a Doctor
One must consult a doctor if there are brown colored lesions on skin which are rapidly growing in size and number.
Systems involved
Integumentary system, circulatory system.
Organs involved
Skin
