title: Leser-Trélat sign presenting in a patient with recurrent pre-B-cell acute lymphocytic leukemia.
abstract: The presence of multiple seborrheic keratoses appearing abruptly in association with an underlying malignancy is known as Leser-Trélat sign, a rare paraneoplastic cutaneous syndrome. Although this finding is most commonly associated with solid organ tumors, it also can be a clue for the presence of underlying hematologic malignancies. We present a unique case of Leser-Trélat sign in a 20-year-old man who experienced a relapse of pre-B-cell acute lymphocytic leukemia (ALL) that was previously treated with multiple courses of chemotherapy and external radiation therapy. The patient was admitted for a new cycle of chemotherapy with etoposide and cyclophosphamide and was noted to have an eruption of yellowish brown papules and plaques over his upper body. Biopsy of a representative lesion was consistent with seborrheic keratosis. A large number of rapidly appearing seborrheic keratoses is an uncommon finding in young patients and should be considered clinically suspicious as a potential indicator of Leser-Trélat sign. A thorough history and physical examination should be performed in patients presenting with this sign to rule out possible internal solid organ and hematologic malignancies.
authors.affiliation: Naval Hospital, Jacksonville, Florida, USA. jerry.fasoldt@med.navy.mil
authors.forename: Jerry J
authors.initials: JJ
authors.lastname: Fasoldt
authors.forename: Eric R
authors.initials: ER
authors.lastname: Brumwell
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Lackey
mesh_terms: D000208:Acute Disease; D000328:Adult; D006801:Humans; D017492:Keratosis, Seborrheic / Q000209:etiology* / Q000473:pathology; D015448:Leukemia, B-Cell / Q000150:complications*; D008297:Male; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000473:pathology; D011230:Precancerous Conditions / Q000150:complications*; D012008:Recurrence; D055815:Young Adult