title: The sign of Leser-Trélat in a case of adenocarcinoma of the lung.
abstract: 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-alpha [TGF-alpha]) 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.
authors.affiliation: Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Heaphy
authors.forename: J L
authors.initials: JL
authors.lastname: Millns
authors.forename: A L
authors.initials: AL
authors.lastname: Schroeter
mesh_terms: D000052:Acanthosis Nigricans / Q000175:diagnosis* / Q000473:pathology; D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D001706:Biopsy; D005260:Female; D006801:Humans; D017492:Keratosis, Seborrheic / Q000175:diagnosis* / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000473:pathology; D012867:Skin / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D014409:Tumor Necrosis Factor-alpha