chemamr
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What´s the most common cause of this sign?? ...... which is the most common site of origin?
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| an
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a paraneoplastic syndrome..multiple seborrheic keratosis...a sign of an internal malignancy(of GIT/lung/breast)..
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| chemamr
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good work an!
now, the 2nd question was: which is the most common site of origin? i meant, the most common Primary tumor?
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| mash
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stomach
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| chemamr
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 according to UW, the MCC is colon cancer.
which is your source mash?
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| mash
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may be goljan but dont remember exactly..
i checked a few sites(emedicine/ dermnetz) and acc to that adenocarcinoma of stomach or colon is the most common malignancy asso with it..
if i find out something else i ll let u know...
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| chemamr
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alright. Meanwhile, we can have as an answer: Stomach or Colon Adenocarcinoma are the MCCs.
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| achilles
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the sign of leser trelat is a very very rare paraneoplastic finding in patients who have a internal malignancy of the lungs,breast,GIT,lymphoma and leukemias.Most commonly it is associated with adnenocarcinoma of the colon or the stomach ( which one is more common of the two , i dont know ).
it is seen more in older individuals although there are 2 people between the ages of 10 and 20 who have been documented with this sign.
the noteworthy point is the abruptness of the appearance of this sign as opposed to generalised seborrheic keratosis which is gradual in onset.
The leser trelat sign is seen more on the trunk and pruritus is the most common presentation alongwith the characteristic eruption.
The sign of Leser-Trélat should be considered part of a spectrum of eruptions with internal malignancy that occur relatively commonly with acanthosis nigricans. The associated malignancy is usually aggressive and usually has a poor prognosis. However, neither malignant acanthosis nigricans nor malignancy-induced multiple seborrheic keratoses are cancerous.
this was just to add a bit more information.to be frank i had read about this sometime back and thanks chemamr for asking about it ... cause i read it again and now it is once again fresh in my mind.
good luck.
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| aimhigh
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Gastric adenocarcinoma is more related to florid cutaneous papillomatosis than eruptive sebarric keratosis (the leser trelat sign). Both of two signs are para-neoplastic and related to underlying malignancies.
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| TahoeEd
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My wife has just been diagnosed with this rare sign. She is 39. We are beginning the series of tests to locate the malignancy. Any additional information or resouces that any of you mat be able to provide is greatly appreciated.
Her history: 3cm polyp removed from cecum in a colonectomy (about 8 in. removed) in Oct 2004. Baruim CT scan indicated possible abnormality in cecum again, after only 16 months. She developed a rash in September on her legs, a second, more severe rash developed on her chest. Biopsies revealed sebarric keratosis. Apparenlty a very rare finding for her age.
We are scared. Any advice, or help is appreciated.
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| Roger
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My girlfriend just had a check today on what we thought were birthmarks (naevi), turned out they are Seborrheic Keratoses. She is 29, doctor told her it was rare for her age and mentioned the possibility of Leser-Trelat. She'll be checked for internal malignancy next month.
I am very worried, is there a serious risk on internal malignancy or is it very well possible that she simply got the Seb K's younger than usual?
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| TahoeEd
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Roger,
We got good news yesterday... A second biposy (deeper tissue cut) revealed that the rash is Darier's disease (keratosis follicularis). He explained that the pathology on a surface review would easily be mistaken for LT, but a look deeper through the layers of tissue revealed the Darier's disease.
Please have your girlfriend get a second opinion and be sure the biopsy is deep enough to get to the lower layes of skin. Darier's is treatable. We are just releived that there is no cancer, and after all the scans, tests, probes, x-rays, bloor drawn... we KNOW she's cancer free!
This is a HUGE relief since there is very little information available on LT anywhere. Good luck!
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| Roger
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TahoeEd, congratulations, that's great news!
My girlfriend will have a further investigation next week, and we'll make sure to mention this. They were not very familiar with LT as it seems pretty rare, so I rather not take the risk of them confusing it with Darier's.
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| p53
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what's the name of presumed substance by which internal malignancy causes LT sign?
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| babli
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alpha transforming growth factor.
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| p53
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yes - transforming growth factor alpha.
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