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doctorkarim · Credits: 84453 My Scrapbook

A 64-year-old patient is referred to Dermatology outpatients due to a rash. A diagnosis necrolytic migratory erythema of is made. What is the most likely underlying diagnosis?
A.Gastrinoma
B.Lung cancer
C.Glucagonoma
D.Pancreatic cancer
E.Lymphoma

mikebrian · Credits: 719 My Scrapbook

C.Glucagonoma

cafe · Credits: 5230 My Scrapbook

Necrolytic migratory erythema is a characteristic rash usually occurring in the glucagonoma syndrome. Glucagonoma syndrome is due to a slow-growing cancerous tumour located in the alpha cells of the pancreas. Glucagonoma is very rare and affects adults over the age of 50. The tumour secretes excessive amounts of the hormone glucagon.

The results of excessive glucagon also include:

Diabetes mellitus
Weight loss
Diarrhoea
Neurological and psychiatric symptoms
Venous thrombosis (blood clots)
Anaemia
Low levels of circulating amino acids
Other medical conditions may result in a similar rash:

Hepatic cirrhosis
Coeliac disease
Cystic fibrosis causing intestinal malabsorption
Nutritional deficiencies of amino acid, zinc, and essential fatty acids

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