What is the significance and management of the sign of lesser Trelat?

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Last updated: June 20, 2025View editorial policy

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From the Research

The sign of lesser Trelat is a rare paraneoplastic cutaneous marker of internal malignancy characterized by the sudden eruption of multiple seborrheic keratoses, and its management involves identifying and treating the underlying malignancy. The sign of lesser Trelat is clinically significant as it is associated with various internal malignancies, including gastrointestinal adenocarcinomas, breast cancer, lymphoproliferative disorders, and other cancers 1. When encountered, a thorough history and physical examination should be performed to rule out possible internal malignancies.

Key Points

  • The sign of lesser Trelat is a rare paraneoplastic syndrome that presents with the sudden eruption of multiple seborrheic keratoses 2.
  • It is most commonly associated with gastrointestinal adenocarcinomas, particularly gastric adenocarcinoma 1.
  • The management of the sign of lesser Trelat involves identifying and treating the underlying malignancy, which can lead to the resolution of the seborrheic keratoses 1.
  • Pruritus occurs in half of the patients with the sign of lesser Trelat, and the lesions rarely require any treatment other than management of the underlying malignancy 1.

Diagnosis and Treatment

The diagnosis of the sign of lesser Trelat involves a thorough history and physical examination, as well as laboratory tests and imaging studies to identify the underlying malignancy.

  • A biopsy of a representative lesion can confirm the diagnosis of seborrheic keratosis 2.
  • Treatment of the underlying malignancy can lead to the resolution of the seborrheic keratoses, and may involve surgery, chemotherapy, or radiation therapy 3.

Prognosis

The prognosis of the sign of lesser Trelat depends on the underlying malignancy and its treatment.

  • Early diagnosis and treatment of the underlying malignancy can improve the prognosis and reduce the risk of mortality 4.
  • The sign of lesser Trelat can be a rare manifestation of cutaneous melanoma, and an accurate skin examination with dermatoscopy can aid in early diagnosis and treatment 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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