Coexistence of acanthosis nigricans and the sign of Leser-Trelat in a patient with gastric adenocarcinoma: A case report and literature review

The association of acanthosis nigricans (AN) with the sign of Leser-Trelat (LT) and gastric carcinoma is rare. Our patient was a 69-year-old man, who presented with hematemesis; a stage IV poorly differentiated, diffuse type, adenocarcinoma of the gastric antrum was diagnosed. The AN was striking, w ith florid cutaneous papillomatosis that also involved the mucous membranes of the mouth and eyelids, and keratoderma. AN and the sign of LT predated tumor detection by 6 months and regressed after chemotherapy in parallel wi th reduction of the tumor load, demonstrating the dermatoses as paraneoplas tic phenomena. The patient died 7 months after completion of chemotherapy. The coexistence of AN and the sign of LT should prompt a search for underly ing malignancy The pathogenesis of both dermatoses is discussed.