Yeh J S, Munn S E, Plunkett T A, Harper P G, Hopster D J, du Vivier A W
Department of Dermatology, King's College Hospital, London, United Kingdom.
J Am Acad Dermatol. 2000 Feb;42(2 Pt 2):357-62. doi: 10.1016/s0190-9622(00)90112-9.
The association of acanthosis nigricans (AN) with the sign of Leser-Trélat (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, with 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 with reduction of the tumor load, demonstrating the dermatoses as paraneoplastic phenomena. The patient died 7 months after completion of chemotherapy. The coexistence of AN and the sign of LT should prompt a search for underlying malignancy. The pathogenesis of both dermatoses is discussed.
黑棘皮病（AN）与Leser-Trélat征（LT）及胃癌的关联较为罕见。我们的患者是一名69岁男性，因呕血就诊；诊断为胃窦部IV期低分化弥漫型腺癌。黑棘皮病表现显著，有明显的皮肤乳头瘤病，累及口腔和眼睑黏膜以及角化病。黑棘皮病和Leser-Trélat征在肿瘤被发现前6个月就已出现，化疗后随着肿瘤负荷减轻而消退，表明这些皮肤病是副肿瘤现象。患者在化疗结束7个月后死亡。黑棘皮病和Leser-Trélat征的共存应促使寻找潜在的恶性肿瘤。本文讨论了这两种皮肤病的发病机制。
