Leser-Trelat sign in metastasized malignant melanoma

Eur Arch Otorhinolaryngol. 2009 Feb;266(2):297-9. doi: 10.1007/s00405-008-0636-6. Epub 2008 Mar 28.


The Leser-Trelat sign is defined as the association of multiple, eruptive seborrheic keratoses with an internal malignancy of a usually advanced stage. We report the case of malignant melanoma in an 82-year-old man covered with hundreds of greyish-dark seborrheic keratoses resembling a Christmas tree pattern, who was diagnosed with metastasized malignant melanoma involving the parotid gland and lymph nodes. Though the pathogenesis of Leser-Trelat sign is still unknown, spontaneous regression of the seborrheic keratoses following tumor reduction described in some cases argues for a paraneoplastic origin of this highly instructive clinical entity. Physicians should consider a workup for internal malignancy in patients presenting with multiple eruptive seborrheic keratoses.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Biomarkers, Tumor
  • Dacarbazine / administration & dosage
  • Follow-Up Studies
  • Humans
  • Keratosis, Seborrheic / drug therapy
  • Keratosis, Seborrheic / pathology*
  • Lymphatic Metastasis
  • Male
  • Melanoma / drug therapy
  • Melanoma / pathology*
  • Melanoma / secondary*
  • Neoplasm Staging
  • Palliative Care / methods
  • Paraneoplastic Syndromes / drug therapy
  • Paraneoplastic Syndromes / pathology*
  • Risk Assessment
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology*


  • Biomarkers, Tumor
  • Dacarbazine