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Necrolytic migratory erythema: a fortuitous diagnosis
A woman in her late 60s presented with widespread, itchy, dark lesions over her trunk and legs for 1 month. Initially, she was managed as nutritional dermatitis and experienced partial improvement. However, her condition worsened over 2 months, characterised by aggravated skin lesions, new-onset diabetes and a 12 kg weight loss. On suspicion of necrolytic migratory erythema (NME) secondary to glucagonoma, the contrast-enhanced CT (CECT) abdomen revealed a primary pancreatic lesion with multiple liver metastases. The diagnosis of neuroendocrine tumour was confirmed by liver biopsy with immunohistochemistry, and stage 4 status was revealed by fluorodeoxyglucose-positron emission tomography CT. Following 6-monthly octreotide injections and nutritional and supportive care, her skin lesions completely resolved. This case emphasises the significance of recognising NME, a rare and often misdiagnosed dermatological condition, as it may signify an underlying occult neuroendocrine panc reatic malignancy. Early recognition is crucial for the timely initiation of appropriate management. © BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.
Authors : Kanagarajan A.; Babu D.; Chandrasekaran S.
Source : BMJ Publishing Group
Article Information
| Year | 2024 |
| Type | Article |
| DOI | 10.1136/bcr-2024-260893 |
| ISSN | 1757790X |
| Volume | 17 |
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