Cutaneous markers of malignancy: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Cutaneous markers of malignancy

Sample item

A 65-year-old man develops a sudden eruption of numerous itchy seborrhoeic keratoses over his trunk, along with weight loss. This sign suggests which internal condition?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Gastrointestinal adenocarcinoma

The sign of Leser-Trelat is the sudden appearance or rapid increase in size and number of seborrhoeic keratoses, associated with an internal malignancy, most often gastric or colonic adenocarcinoma. A search for the primary is indicated, and the link is thought to be mediated by growth factors.

Option by option

  • A. Gastrointestinal adenocarcinoma (correct)

    Correct. The sign is a paraneoplastic marker, most often with GI adenocarcinoma.

  • B. Primary biliary cholangitis

    Primary biliary cholangitis causes pruritus and xanthelasma.

  • C. Chronic kidney disease

    Chronic kidney disease causes pruritus and uraemic frost, not this sign.

  • D. Hypothyroidism

    Hypothyroidism causes dry skin and myxoedema rather than seborrhoeic keratoses.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Gastrointestinal adenocarcinoma. The sign of Leser-Trelat is the sudden appearance or rapid increase in size and number of seborrhoeic keratoses, associated with an internal malignancy, most often gastric or colonic adenocarcinoma.

Why is "Primary biliary cholangitis" not the answer?

Primary biliary cholangitis causes pruritus and xanthelasma.

Why is "Chronic kidney disease" not the answer?

Chronic kidney disease causes pruritus and uraemic frost, not this sign.

Why is "Hypothyroidism" not the answer?

Hypothyroidism causes dry skin and myxoedema rather than seborrhoeic keratoses.

What concept does this question test?

It tests Cutaneous markers of malignancy in Dermatology. A search for the primary is indicated, and the link is thought to be mediated by growth factors.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cutaneous markers of malignancy?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.