NECROLYTIC MIGRATORY ERYTHEMA

Course overview

NECROLYTIC MIGRATORY ERYTHEMA (NME) IS A CHARACTERISTIC SKIN RASH MOST OFTEN ASSOCIATED WITH GLUCAGONOMA, AN ALPHA-CELL TUMOR OF THE PANCREATIC ISLETS. IT IS USUALLY SEEN AS A PART OF THE GLUCAGONOMA SYNDROME, A PARANEOPLASTIC SYNDROME THAT INCLUDES THE TRIAD OF DIABETES MELLITUS, NME, AND WEIGHT LOSS. HOWEVER, MORE RARELY, NME CAN ALSO BE SEEN AS A PART OF OTHER CLINICAL ENTITIES SUCH AS LIVER DISEASE AND INTESTINAL MALABSORPTION; HERE, IT IS TERMED THE PSEUDOGLUCAGONOMA SYNDROME. THE SKIN RASH IS CHARACTERISTICALLY EXTREMELY ERYTHEMATOUS, SHOWS SUPERFICIAL EPIDERMAL NECROSIS, AND OFTEN SPREADS IN A CENTRIFUGAL PATTERN. THE CONDITION IS FREQUENTLY MISDIAGNOSED DUE IN PART TO ITS RARITY. IT IS THE PRESENTING SYMPTOM OF THE PANCREATIC ISLET NEOPLASM. THUS, TIMELY RECOGNITION AND TREATMENT CAN HELP PREVENT MORBIDITY FROM THE EPIDERMAL DYSFUNCTION AND MORTALITY FROM THE TUMOR BURDEN ITSELF IF THE NEOPLASM IS IDENTIFIED BEFORE METASTASIS. THIS ACTIVITY REVIEWS THE CAUSE, PATHOPHYSIOLOGY, AND PRESENTATION OF NECROLYTIC MIGRATORY ERYTHEMA AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN ITS MANAGEMENT.