Transient eruptive seborrheic keratoses associated with erythrodermic psoriasis and erythrodermic drug eruption: report of two cases

Abstract

The appearance of multiple seborrheic keratoses in association with underlying internal malignancy (known as the sign of Leser-Trelat) has generated much discussion and debate in the literature. However, comparatively few case reports exist that examine the appearance of multiple seborrheic keratoses associated with exfoliative erythroderma without underlying malignancy. We report 2 cases in which multiple, biopsy-proven seborrheic keratoses appeared in conjunction with erythrodermic skin eruptions. The underlying diseases in these 2 patients included psoriasis and an eczematous drug eruption; in both cases the erythroderma resolved with appropriate treatment. After resolution of the erythroderma, the newly developed seborrheic keratoses proceeded to involute and gradually fall off. Neither of the patients exhibited any evidence of internal malignancy. These cases represent the first reports of psoriasis and drug eruption as causes of erythroderma-induced transient eruptive seborrheic keratoses. Clinical and pathologic findings are consistent with previous descriptions of this entity.