Reader Trélat Syndrome

At the Reader Trélat Syndrome a malignant cancer of the internal organs occurs in patients of old age, which is accompanied by numerous old warts. Often the phenomenon is also accompanied by itching and acanthosis nigricans. Therapy includes removing the warts and treating the tumor.

What is Reader Trélat Syndrome?

The Reader Trélat Syndrome is a rare and paraneoplastic syndrome that occurs mainly in older people. Those affected by the disease grow numerous old warts. The namesake of the phenomenon are its first descriptive readers and Trélat, who discovered the phenomenon back in the 19th century. Their discoveries were unrelated. It later emerged that both had actually described the senile hemangioma.

E. Hollander is also connected to research into the Reader Trelat Syndrome. In the 20th century, he speculated about a causal connection between old age keratoses and malignancies of the internal organs. To this day, however, it is difficult to prove that the reader-Trélat syndrome is actually causally related to a malignant cancer and is therefore doubted by numerous authors.

causes

When it comes to the causes of Reader-Trélat Syndrome, science is divided. Some scientists consider E. Hollander's speculations to be justified and assume that another cancer is the cause of the old age warts. Usually, according to this opinion, the phenomenon is triggered by a malignant tumor such as adenocarcinoma of the gastrointestinal tract or the breast, which are supposed to release stimulating growth factors.

Malignant lymphomas, leukemia or lung carcinomas are said to be able to trigger the phenomenon just as often. Since the connection with other tumors is difficult to prove, the other half of science doubts the causal connection with carcinomas of the internal organs. In about 30 percent of the cases, the skin disease Acanthosis nigricans is present at the same time as the Reader-Trélat syndrome. Therefore, the phenomenon is considered by many authors to be an incomplete form of this dermatological disease.

Symptoms, ailments & signs

The main symptom of the Reader-Trélat syndrome is sudden seborrheic keratosis. The age warts occur in the context of the syndrome particularly numerous and rather diffusely distributed. A special characteristic can be observed on the trunk of the body. In half of all cases, age warts are associated with more or less severe itching. From seborrheic keratoses in the sense of generalized skin rashes, the old warts of the Reader-Trélat syndrome differ in that there is usually an additional malignancy in the internal organs.

Even if carcinomas of the internal organs may not be the cause of the phenomenon, there is an undisputed connection between a malignant cancer and the warts in the case of the Reader-Trélat syndrome. In addition, dirty brown to gray changes in the skin can occur as part of the syndrome. In this context, the arms and legs of the patient in particular appear comparatively heavily pigmented.

Diagnosis & course of disease

The first suspicion of the reader-Trélat syndrome arises from eye diagnosis. The anamnesis can already confirm the diagnosis if the patient reports of a carcinoma of the internal organs during the anamnesis discussion. If a malignant cancer of the internal organs has not yet been diagnosed, the doctor localizes existing tumors by imaging if he suspects Reader-Trélat syndrome.

At the latest, the detection of these tumors in connection with the age warts is considered to confirm the diagnosis of the syndrome. In order to assess the malignancy of the carcinoma and to be able to give a prognosis, the doctor usually orientates himself on the WHO. The prognosis for the Reader-Trélat syndrome differs from case to case and is largely determined by the underlying tumor, its localization and treatability.

Complications

Since the Reader-Trélat syndrome is a tumor, in the worst case it can lead to the patient's death. However, this only occurs if treatment of the syndrome is not initiated early and the diagnosis is made late. The patients suffer mainly from itching and severe rashes on the skin.

The symptoms also lead to reduced aesthetics for the patient. Furthermore, the reader-Trélat syndrome leads to the development of warts on the skin. The warts themselves are very dark. If there is no treatment, the disease can continue to spread and affect other healthy areas in the body. For this reason, immediate treatment is necessary.

The affected regions can be removed by surgery. However, it cannot be universally predicted whether the cancer will be completely defeated by removal. Reader Trélat syndrome may reduce the life expectancy of those affected. Radiation can also be used to treat the symptoms and symptoms of Reader Trélat Syndrome. However, the treatment itself does not lead to any further complications.

When should you go to the doctor?

Older people who suddenly notice changes in their skin or who experience unusual itching should contact their family doctor. Medical treatment is required at the latest when severe rashes or the characteristic warts appear. Otherwise, the growths can spread to healthy areas of the body and cause further complications as the disease progresses. If there is severe pain, the emergency doctor must be called immediately. The same applies to cardiovascular problems and shortness of breath.

Reader-Trélat syndrome occurs predominantly in the elderly. Seniors who suffer from the symptoms mentioned or who have already had cancer should consult their doctor closely. A full physical examination is always indicated. The right contact point is your family doctor or a dermatologist.

Anyone who feels uncomfortable as a result of the external changes should arrange a consultation with a therapist before serious symptoms develop. Pronounced inferiority complexes or depression require long-term therapy. With children, the pediatrician should be consulted if there are signs of Reader-Trélat syndrome.

Treatment & Therapy

If metastases have already formed, a curative treatment of a carcinoma is no longer possible in the context of Reader-Trélat syndrome. Need-based surgery and symptomatic treatments can potentially extend patients' lives. However, life expectancy for an aggressive course is around eleven months.

In the absence of metastases, therapy for Leser Trélat syndrome focuses on surgical removal of the tumor. Irradiation may also be used to kill cancer cells that have remained in the body. The age warts on the skin are also usually removed. The removal can take place, for example, by means of excision. Alternatively, cryotherapy offers the option of freezing the affected area.

The affected tissue is either treated externally using a cold probe or the coolant is injected directly into the warts. In any case, cryotherapy works with temperatures between minus 70 and minus 200 degrees Celsius. A third option is curettage. The pathologically altered tissue is surgically removed by scraping off the warts with a curette. Usually the procedures to remove the warts take place under local anesthesia and do not require general anesthesia.

Outlook & forecast

The prognosis of the disease is based on the general health of the person affected and the progression of the disease. A particularly severe course can lead to a premature death of the person concerned. The cancer cells can spread unhindered in the organism, especially without medical care, and lead to the formation of metastases. This process ultimately results in the death of the person concerned.

Since the Reader-Trélat syndrome is characterized by a particularly aggressive form, adequate treatment measures must be taken in the early stages for a favorable prognosis. However, since the change in skin appearance mostly occurs in older people, their general state of health is usually already weakened. This has a negative impact on further development. Cancer therapy is imperative in order for a cure to exist. The treatment measures place a heavy burden on the human organism. There are side effects and a loss of quality of life. Nevertheless, it is often the only way to be free of symptoms.

In addition, the treatment requires surgery to remove the malignant tumors. The procedure is also associated with risks and side effects. If the lesions on the skin cannot be completely removed, the prospect of recovery worsens. There is also an increased likelihood of the disease returning.

prevention

As the causal factor of the reader-Trélat syndrome has not yet been conclusively researched, this disease is difficult to prevent. If a cancer of the internal organs is actually the cause, the genetic level for the onset of the disease plays a role that should not be underestimated. In the case of genetic dispositions, all preventive measures are only effective to a limited extent.

Aftercare

After the actual treatment of the reader Trélat syndrome, those affected need ongoing care. In addition to regular medical examinations and the use of other therapies, a change in lifestyle is also part of the follow-up care. Those affected should try to build quality of life again.

The support of the responsible doctors as well as relatives and friends is important in order to get a good handling of the disease. Exchanging ideas with people who are equally ill can also help to obtain valuable information that improves the quality of life. Most patients also suffer from depression or other psychological upsets due to the aesthetic complaints. The changes on the skin can occur in different places and reduce the quality of life of the person affected.

Reader-Trélat syndrome can also occur in the internal organs and lead to cancer there too. The further course of this disease therefore depends very much on the time of diagnosis and also on the region affected, so that a general prediction is usually not possible. In many cases, however, the life expectancy of the person affected is reduced.

The risk of relapse decreases every year. As a rule of thumb, five years apply, whereby the type of cancer is also decisive here. Medical rehabilitation may also include taking antihormones and other medications. In the case of protracted illnesses, follow-up checks and follow-up care merge. The details of aftercare will be discussed during the discharge interview or at a separate appointment.

You can do that yourself

Reader Trélat syndrome poses a threat to the life of the sick person, so a doctor must be seen immediately. Although the patients suffer from the aesthetic flaw caused by the old age warts, the treatment of the malignant tumor on the internal organs comes first. As a result of the diagnosis, the patients usually experience considerable emotional stress and feel restricted in their quality of life. However, emerging depression must by no means lead to patients postponing therapy due to a lack of motivation.

After all, when removing the malignant tumor, it is essential for the success of the treatment that the doctors perform the operation as quickly as possible. This is associated with a stay in a clinic, whereby the patients adhere to the medical regulations with regard to physical activity, rest periods and the intake of medicinal substances.

After the tumor has been removed, many patients want a cosmetic treatment for age warts, which they find unattractive and annoying. A dermatologist will remove the age warts. Subsequently, the sufferers take care not to put additional stress on the irritated areas of the skin. The dermatologist gives the patient advice on personal hygiene, the use of cosmetic products and the choice of clothing, which the person concerned follows for a few weeks.