LESER–TRÉLAT ZNAK KAO PARANEOPLASTIČNA MANIFESTACIJA MALIGNITETA: PREGLED LITERATURE
Sažetak
Uvod/Cilj: Leser–Trélat znak predstavlja paraneoplastičnu dermatozu koju karakteriše nagla i eruptivna pojava seboroičnih keratoza. Promene se najčešće javljaju u kratkom vremenskom intervalu, a često su praćene izraženim pruritusom, što dodatno skreće pažnju na mogućnost paraneoplastične etiologije. Patofiziološki mehanizam nije u potpunosti razjašnjen, ali se smatra da tumorske ćelije produkuju faktore rasta koji stimulišu proliferaciju keratinocita i dovode do naglog razvoja lezija. U literaturi se ovaj znak najčešće dovodi u vezu sa adenokarcinomima gastrointestinalnog trakta, među kojima se izdvaja adenokarcinom želuca, ali je opisana povezanost i sa drugim solidnim tumorima, kao i sa hematološkim malignitetima. Zbog moguće povezanosti sa neotkrivenom neoplazmom, pojava Leser–Trélat znaka zahteva ozbiljan klinički pristup i sistematsku dijagnostičku obradu, jer njegovo pravovremeno prepoznavanje može omogućiti otkrivanje osnovnog maligniteta u ranoj fazi bolesti. Cilj rada je analiza podataka iz dostupne literature o etiologiji, patogenezi i kliničkoj povezanosti Leser–Trélat znaka sa različitim malignitetima, kao i razmatranje njegovog dijagnostičkog i prognostičkog značaja u savremenoj kliničkoj praksi.
Metode: Izvršen je pregled literature pretragom baze podataka PubMed, pri čemu su obuhvaćeni dostupni originalni radovi, pregledni članci, prikazi slučaja i serije slučajeva. Pretraga je sprovedena korišćenjem sledećih ključnih reči: „Leser–Trélat sign”, „paraneoplastic dermatosis”, „seborrheic keratoses” i „malignancy”.
Zaključak: Informisanje o Leser–Trélat znaku i multidisciplinarni pristup u otkrivanju njegove povezanosti sa malignitetima presudni su ranom otkrivanju neoplazmi. Prepoznavanje Leser–Trélat znaka može omogućiti dijagnostikovanje maligniteta u fazi kada je terapijski odgovor povoljniji, što značajno utiče na prognozu bolesti.
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