Leser-Trélat Associated with Myeloproliferative Neoplasia: When the Skin Speaks

The Leser-Trélat sign is an uncommon dermatological manifestation characterized by the sudden and rapid onset of multiple seborrheic keratoses, variably distributed across the body. Its clinical significance lies in its association with underlying neoplasms, primarily solid tumors such as gastric, colon, and breast adenocarcinomas. Less frequently, it has been linked to hematological and lymphoid malignancies, reinforcing its role as a paraneoplastic syndrome. These lesions may appear as an isolated finding or alongside other systemic signs, emphasizing the importance of a comprehensive diagnostic approach to identify potential associated neoplasms. We present the case of a 72-year-old male patient who sought medical attention for constitutional symptoms, fever, nocturnal chills, and abdominal distension. Sudden-onset brown seborrheic and keratotic lesions were noted on his chest, back, abdomen, axillary, and cervical regions. Following evaluation, the patient was diagnosed with chronic myeloid leukemia. Given his advanced age and clinical condition, a palliative approach was chosen due to the high risk of complications with chemotherapy, and the patient was subsequently discharged. This case highlights the importance of recognizing the Leser-Trélat sign as a critical clinical marker for occult neoplasms. Its identification should prompt a thorough evaluation, particularly in patients with systemic symptoms, as it may provide the key to early diagnosis and optimized therapeutic planning.