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Journal of the American Academy of Dermatology
Volume 38, n° 5S
pages 866-873 (mai 1998)
Doi : 10.1016/S0190-9622(98)70478-5
Iatrogenic necrolytic migratory erythema: A case report and review of nonglucagonoma-associated necrolytic migratory erythema

Elizabeth A. Mullans, MDa, Philip R. Cohen, MDa,b,c
Houston Texas 
From the Departments of Dermatologya and Pathology,b University of Texas-Houston Medical School, and Department of Medical Specialties (Section of Dermatology),c University of Texas M.D. Anderson Cancer Center 


Necrolytic migratory erythema is characterized by waves of irregular erythema in which a central bulla develops, and subsequently erodes and becomes crusted. It usually occurs in patients with an alpha-islet cell tumor of the pancreas. However, necrolytic migratory erythema has also been observed in patients without an associated glucagonoma. We describe a woman with iatrogenic necrolytic migratory erythema. She received intravenous glucagon for hypoglycemia associated with an insulin-like growth factor II-secreting hemangiopericytoma. After chemotherapy, she developed necrolytic migratory erythema. The characteristics of the previously reported patients with nonglucagonoma-associated necrolytic migratory erythema are reviewed. In patients with nonglucagonoma-associated necrolytic migratory erythema, the dermatosis-related conditions most commonly observed were celiac disease or malabsorption, cirrhosis, malignancy, and pancreatitis; less common conditions included hepatitis, inflammatory bowel disease, heroin abuse, and odontogenic abscess. Although the pathogenesis of necrolytic migratory erythema remains unknown, hyperglucagonemia appears to have had a causative role in the development of this dermatosis in our patient. Patients who develop necrolytic migratory erythema should be evaluated for the presence of a glucagonoma; if a glucagonoma is ruled out, evaluation for other conditions known to occur with necrolytic migratory erythema, such as liver disease, malabsorptive disorders, and nonislet-cell tumors is warranted. (J Am Acad Dermatol 1998;38:866-73.)

The full text of this article is available in PDF format.

 This article is made possible through an educational grant from Ortho Dermatological.
 Reprint requests to: Philip R. Cohen, MD, Department of Dermatology, University of Texas-Houston Medical School, 6431 Fannin, Suite 1.186, Houston, TX 77030.
 0190-9622/98/$5.00 + 0 16/4/87648

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