Leser-Trelat Sign and Its Main Features: A Systematic Literature Review

Abstract

Leser-Trélat sign (TLS) is a rare paraneoplastic syndrome characterized by the sudden onset of multiple seborrheic keratoses (QS), indicating an underlying malignancy. The cancers most associated with TLS occur in the gastrointestinal tract and, as they are more common in elderly people, some authors question its legitimacy as a predictor of malignancy. So, this study aimed to compile all case reports published in the last ten years, to analyze their common characteristics, such as the sex and age of the people affected, as well as the main associated malignancies, the evolution of skin lesions and its relationship with the onset of cancer. A bibliographic search was carried out in the databases: Medical Literature Analysis and Retrieval System Online (Medline) via PubMed, Scientific Electronic Library Online (SciELO) and Latin American and Caribbean Literature in Health Sciences (LILACS), using the term: Leser-Trelat. Based on the selection criteria, 13 articles were included in this study and it was found that the disease is more common in the elderly, with no sex predilection. The most common location of QS was on the back and chest, with sudden onset and with a higher occurrence of gastric and hepatocellular adenocarcinoma, in addition to cutaneous T lymphoma. Despite the need for more studies to improve the understanding of the disease, it is concluded that TLS must indeed be considered a paraneoplastic syndrome and, therefore, an omen for screening for hidden malignancies.