The Leser-Trélat Sign: A Dermatologist’s Life-Saving Encounter
The Mark of Time and the Unspoken Truth
There are moments in life when silence is a betrayal. In the dim, chlorinated expanse of the pool, where the water folds over the body like memory, I recognized something more than just the disciplined strokes of a man I had once known only in passing. His back was a constellation of lesions—raised, waxy, scattered like inkblots on parchment, multiplying in a way that skin should not. It was the sign of Leser-Trélat, the cutaneous whisper of something far graver beneath.
The Leser-Trélat sign is a rare but critical dermatologic phenomenon—an abrupt eruption of seborrheic keratoses, sometimes accompanied by pruritus. While seborrheic keratoses themselves are benign, harmless growths common with aging, their sudden onset in large numbers can be a sign of an underlying malignancy, most notably gastrointestinal adenocarcinomas, including colon cancer. The mechanism behind this sign remains under investigation, but it is believed to be linked to tumor-derived growth factors that stimulate epidermal proliferation. Recognizing this association is vital, as it can lead to early cancer detection and intervention.
Seborrheic keratoses, in their typical form, are nothing more than cosmetic nuisances—superficial, well-demarcated, waxy, and ranging in color from tan to dark brown. They pose no medical risk and require no treatment unless they become irritated, inflamed, or aesthetically undesirable. In my practice at 629 Park Avenue, I routinely remove them with electrosurgery—a precise and effective technique using high-frequency electrical currents to cauterize and vaporize the growths, leaving the surrounding skin unharmed. Patients walk out of my office with clear skin, free of these harmless lesions. But when they present as they did on this swimmer, their presence takes on a far greater significance.
I hesitated. What right did I have to speak on the architecture of another man’s body, to disturb the uneasy peace of the unaware? But truth is an obligation, and medicine is not merely science; it is the art of seeing, of deciphering, of daring to voice the inconvenient. So I spoke. With the precision of a scalpel, I told him what I saw, what it meant, and where it must lead him next.
This was no ordinary man—he was a former Olympian swimmer, now in his 40s, a father of young children. The weight of his future was measured not just in his own life, but in the lives of those who depended on him. He took the news with the grace of an athlete—head high, shoulders squared. No fear, only the quiet determination of one accustomed to swimming against currents. He saw his internist, then a gastroenterologist. The verdict came swiftly: colon cancer, but caught in its earliest whisper, before it could roar.
This week, he thanked me. A simple gesture, weighted with the gravity of what might have been. Medicine, like time, is relentless—an ever-moving tide. But in those brief encounters, those moments when knowledge collides with fate, lives are changed. And sometimes, they are saved.
Dr. Gary Jayne Rothfeld
Park Avenue Dermatology and Non-Surgical Rejuvenation Center
629 Park Ave, New York, NY
212-644-4484
nycdermatologist.com
Learn more about the Leser-Trélat sign, early detection of internal malignancies, and seborrheic keratosis removal with electrosurgery.
|
| DR GARY JAYNE ROTHFELD |
