title: Malignant acanthosis nigricans, tripe palms and the sign of Leser-Tre'lat, a hint to the diagnosis of early stage ovarian cancer: a case report and review of the literature.
abstract: BACKGROUND
  Malignant acanthosis nigricans is a mucocutaneous eruption associated with internal malignancies. Tripe palms refers to a characteristic velvety thickening of the palms, with exaggeration of normal skin markings. The sign of Leser-Tre'lat is the presence of multiple seborrheic keratoses and scattered skin tags caused by a malignancy. We are reporting the first case of ovarian cancer in association with three coexisting cutaneous paraneoplastic dermatosis.
  
  
  METHODS
  A 52-year-old female presented with skin manifestation consistent with MAN, TP and the sign of Leser-Tre'lat. Patient underwent extensive work up and was discovered to have stage I, high grade adenocarcinoma of the ovary. Skin manifestations gradually recovered after initiation of chemotherapy.
  
  
  CONCLUSIONS
  The presence of acanthosis nigricans in conjunction with tripe palms and the sign of Leser-Tre'lat are highly suggestive of an internal malignancy and necessitate an extensive investigation in order to discover the underlying malignancy.
authors.affiliation: Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. kebriam@ccf.org
authors.forename: Mehdi M
authors.initials: MM
authors.lastname: Kebria
authors.forename: Jerome
authors.initials: J
authors.lastname: Belinson
authors.forename: Robert
authors.initials: R
authors.lastname: Kim
authors.forename: Tarek M
authors.initials: TM
authors.lastname: Mekhail
mesh_terms: D000052:Acanthosis Nigricans / Q000150:complications; D005260:Female; D006229:Hand Dermatoses / Q000150:complications; D006801:Humans; D007645:Keratoderma, Palmoplantar / Q000150:complications; D017492:Keratosis, Seborrheic / Q000150:complications; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications* / Q000175:diagnosis; D010257:Paraneoplastic Syndromes / Q000150:complications; D012871:Skin Diseases / Q000150:complications*