Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2024; 12(23): 5404-5409
Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5404
Necrolytic migratory erythema caused by pancreatic hyperglycemia with emphasis on therapeutic and prognosis: A case report
Shi-Ping Zhan
Shi-Ping Zhan, Department of Dermatology, General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan 430000, Hubei Province, China
Author contributions: Zhan SP designed the research study; Zhan SP performed the research; Zhan SP contributed new reagents and analytical tools; Zhan SP analyzed the data, wrote the manuscript, and read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Dr. Zhan has nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Ping Zhan, MMed, Doctor, Department of Dermatology, General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, No. 5 Huiji Road, Jiang'an District, Wuhan 430000, Hubei Province, China. 15271841071@163.com
Received: April 8, 2024
Revised: May 10, 2024
Accepted: June 13, 2024
Published online: August 16, 2024
Processing time: 87 Days and 20.6 Hours
Abstract
BACKGROUND

With the incidence of pancreatic diseases increasing year by year, pancreatic hyperglycemia, as one of the common complications, is gradually gaining attention for its impact on the skin health of patients.

CASE SUMMARY

This was the case of an elderly female with clinical manifestations of necrolytic migratory erythema, “three more and one less,” diabetes mellitus, hypertension, anemia, hypoproteinemia, and other syndromes, which had been misdiagnosed as eczema. Abdominal computed tomography showed a pancreatic caudal space-occupying lesion, and the magnetic resonance scanning of the epigastric region with dynamic enhancement and diffusion-weighted imaging suggested a tumor of the pancreatic tail, which was considered to be a neuroendocrine tumor or cystadenoma. The patient was referred to a more equipped hospital for laparoscopic pancreatic tail resection. Post-surgery diagnosis revealed a neuroendocrine tumor in the tail of the pancreas. To date, the patient’s general condition is good, and she is still under close follow-up.

CONCLUSION

Necrolytic migratory erythema can be induced by endocrine system tumors or endocrine metabolic abnormalities, with complex clinical manifestations, difficult diagnosis, and easy misdiagnosis by dermatologists. The initial treatment principles in dermatology include symptomatic supportive therapy and effective drugs to relieve skin lesions. After clarifying the etiology of glucagonoma, comprehensive treatment in collaboration with endocrinologists, general surgeons, and oncologists can help provide individualized treatment for patients and improve their prognosis.

Keywords: Glucagonoma; Necrolytic loosening of wandering erythema; Treatment; Prognosis

Core Tip: This report presented a case of necrolytic migratory erythema, a rare skin condition triggered by pancreatic hyperglycemia. Here, we highlighted the diagnostic challenges, therapeutic strategies, and prognostic considerations in the management of this complex disease.