Migratory necrolytic erythema is seen in:
Ans. is 'a' i.e., Glucagonoma syndrome Migratory necrolytic erythema is seen in Glucagonoma.GlucagonomaIt is an endocrine tumour of the pancreas that secrete excessive amounts of glucagon.The excessive secretion of Glucagon causes following symptoms.Characteristic dermatitis (migratory necrolytic erythema) 67-90%Glucose intolerance (40-90%)Weight loss (66-96%)Anemia (33-85%)Diarrhoea (15-29%)Thromboembolism (11 -24%)Migratory necrolytic erythemaIt is the first manifestation of glucagonoma.The characteristic rash usually starts as an annular erythema at intertriginous and Peri orificial sites, especially in the groin or buttock.It subsequently becomes raised and forms bullae which eventually rupture and leave erosions.These lesions can wax and waneAlso RememberThe diagnosis is confirmed by demonstrating an increased plasma glucagon level. A plasma glucagon level greater than > 1000 pg/ml is considered diagnostic of Glucagonoma.Glucagonoma are most commonly seen in tail of pancreas *Cutaneous manifestations of Sarcoidosis (Harrison 16/e, p 2020)Skin is involved in 25% of patients with sarcoidosis.The common manifestations of skin lesions areErythema nodosum Skin plaquesMaculopapular eruptions subcutaneous nodulesLupus pernio* - Indurated blue purple, swollen, shiny lesions on the nose, cheeks, lips, ears, fingers and knees.Skin manifestation of Amyloidosis -Pink purpura - Pink cutaneous lesions on the face especially on the periorbital and perioral regions and flexural areasPetechiae and purpura can develop following minor trauma therefore the term pinch purpura *.Skin manifestation of Peutz Jeghers syndromeLentigines* i.e. (pigmented lesions following proliferation of melanocytes) are seen, located primarilyaround the nose and mouth and on the hands and feet and within the oral cavity.Skin Markers of malignant diseases * Acanthosis nigricans-Gastrointestinal adenocarcinoma* Necrolytic migratory erythema-Gastrinoma* Dermatomyositis-Bronchogenic carcinoma, carcinoma of breast, carcinoma of genitourinary tract* Pemphigus-Thymoma, lymphoma* Migratory thrombophlebitis-Ca lung, Ca pancreas
Glucagonoma syndrome
Peutz-Jeghers syndrome
Sarcoidosis
Amyloidosis
Infection