Leser-Trelat sign


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Abstract

A male patient aged 74, an inpatient at the chest diseases clinic at Ege University Hospital, ⋖zmir, Turkey with squamous cell carcinoma in the right lung, was referred for consultation to the dermatology outpatient clinic as he presented with itchy papules recently increasing in number and a lesion on his nose with a duration of 2 years. In a lung X-ray taken to investigate hemoptisis, a mass 7 × 5 cm in size was observed on the upper part of the right lung, and as a result of lung biopsy, squamous cell carcinoma (T41MO-phase 3b) was diagnosed. The patient had been smoking 10 cigarettes a day for 60 years and had been taking digoxin for heart insufficiency for 7 years. Biochemical laboratory analyses of the case were observed to be within normal limits and no findings of metastasis were obtained in ultrasonographic and tomographic scanning.In the dermatological examination, an ulceration on the apex nasi, 2 × 1.5 cm in size, covered with crusts, was observed. On the thorax, lesions parallel to one another, linearly distributed, partly pigmented and raised from the skin, having a diameter of 0.5–2 cm, were observed, consistent with seborrheic keratoses (Fig. 1). In addition to these lesions, symmetrically localized, velvety, slightly raised plaques with light brown pigmentation were present on the axillary folds (Fig. 2).Histopathological investigation of the incisional biopsy taken from the apex nasi revealed tumor islands of different sizes. Histopathological changes were found to be in accordance with solid-type basal cell carcinoma. In the histopathological investigation of the incisional biopsy taken from the lesion consistent with seborrheic keratosis, epidermal thickening consisting of basaloid cells and keratin cysts was observed, and the result of the biopsy taken from the axilla was acanthosis nigricans, showing hyperkeratosis, focal acanthosis and papillomatosis in the epidermis.

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