Sign of Leser-Trélat associated with adenocarcinoma of the rectum.
ABSTRACT The acute onset and/or rapid increase in size and number of multiple seborrheic keratoses associated with internal malignancy is called sign of Leser-Trélat. Although some authors reject its existence, there are more than 80 well-documented case reports in the literature. Here, we report a 75-year-old man who presented with abrupt appearance of multiple seborrheic keratoses without any suspicious symptom of cancer. The screening for malignant neoplasms let us detect a rectal adenocarcinoma that was in a curative stage. This case-report illustrates a true sign of Leser-Trélat, and proves that these patients must be appropriately investigated for underlying malignancy.
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ABSTRACT: Cutaneous findings are not uncommonly a concomitant finding in patients afflicted with gastrointestinal (GI) diseases. The dermatologic manifestations may precede clinically evident GI disease. Part I of this 2-part CME review focuses on dermatologic findings as they relate to hereditary and nonhereditary polyposis disorders and paraneoplastic disorders. A number of hereditary GI disorders have an increased risk of colorectal carcinomas. These disorders include familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Each disease has its own cutaneous signature that aids dermatologists in the early diagnosis and detection of hereditary GI malignancy. These disease processes are associated with particular gene mutations that can be used in screening and to guide additional genetic counseling. In addition, there is a group of hamartomatous syndromes, some of which are associated with phosphatase and tensin homolog (PTEN) gene mutations, which present with concurrent skin findings. These include Cowden syndrome, Bannayan-Riley-Ruvalcaba syndrome, and Cronkhite-Canada syndrome. Finally, paraneoplastic disorders are another subcategory of GI diseases associated with cutaneous manifestations, including malignant acanthosis nigricans, Leser-Trélat sign, tylosis, Plummer-Vinson syndrome, necrolytic migratory erythema, perianal extramammary Paget disease, carcinoid syndrome, paraneoplastic dermatomyositis, and paraneoplastic pemphigus. Each of these disease processes have been shown to be associated with an increased risk of GI malignancy. This underscores the important role of dermatologists in the diagnosis, detection, monitoring, and treatment of these disorders while consulting and interacting with their GI colleagues.Journal of the American Academy of Dermatology 02/2013; 68(2):189.e1-189.e21. DOI:10.1016/j.jaad.2012.10.037 · 5.00 Impact Factor
Acta médica colombiana: AMC: organo de la Asociación Columbiana de Medicina Interna 10/2014;
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ABSTRACT: Numerous dermatological disorders have been associated with underlining malignancies of the gastrointestinal (GI) tract. Such cutaneous manifestations might have an important diagnostic value if they are the sole expressions of otherwise asymptomatic carcinomas. The recognition of some typical paraneoplastic dermatologic disorders can lead to the prompt diagnosis of the underlying malignancy, timely administration of therapy, and ultimately, better prognosis. In this review we discuss the most common paraneoplastic dermatological syndromes from the perspective of the practicing gastroenterologist. We also outline a comprehensive practical approach for the evaluation for occult malignancy in patients presenting with cutaneous findings potentially associated with GI cancers.World Journal of Gastroenterology 09/2009; 15(35):4372-9. DOI:10.3748/wjg.15.4372 · 2.43 Impact Factor