Q: 52 year old male is admitted to ICU with malaise, fever, 30 lbs weight loss and electrolyte imbalance. On exam you noticed multiple seborrheic keratoses, often with an inflammatory base in association with skin tags and acanthosis nigricans. Patient informed you that this skin change happened within last 3 weeks. What is your presumptive diagnosis?


Answer: Sign of Leser-Trelat

It is the sudden appearance of multiple seborrheic keratoses, often with an inflammatory base in association with skin tags and acanthosis nigricans. It raises the strong suspicion of malignancy and a manifestation of paraneoplastic syndromes.