Pigmented skin lesions, or keratoses, may appear, including acanthosis nigricans (gastrointestinal cancer), generalized dermic melanosis (lymphoma, melanoma, hepatocellular carcinoma), Bowen disease (lung, gastrointestinal, genitourinary cancer), and large multiple seborrheic keratoses, ie, Leser-Trélat signs (lymphoma, gastrointestinal cancer).