Recurrent Pruritic Polymorphic Lesions Associated With Weight Loss
November 2022
in “
JAAD case reports
”
TLDR A man with itchy skin lesions and weight loss was diagnosed with a rare skin condition linked to a pancreatic tumor.
A 40-year-old man with a 2-year history of recurrent pruritic lesions, weight loss of 33 kg, watery diarrhea, and hyporexia was diagnosed with Necrolytic migratory erythema (NME), a rare paraneoplastic dermatosis associated with glucagonoma. The patient's physical examination revealed polymorphic lesions, some with a necrotic appearance, and diffuse nonscarring alopecia. A computed tomography scan of the abdomen showed an expansive mass in the tail of the pancreas measuring 4.5 × 2.5 cm. The pathophysiological mechanism involved in the etiology of the cutaneous manifestation is hyperglucagonemia, which causes multiple nutrient deficiencies leading to hypoaminoacidemia and can contribute to increased levels of arachidonic acid, prostaglandins, and leukotrienes that cause an inflammatory reaction on the skin.
