Hyperpigmented plaques with erosions and fragile blisters, particularly involving the extremities and intertriginous areas, in a patient with worsening type 2 diabetes mellitus should raise concern for necrolytic migratory erythema (NME). Although rare, NME is a characteristic dermatologic manifestation of glucagonoma. In this case, a biopsy of the patient’s pancreatic mass confirmed the diagnosis. Clinicians should remember that NME may be the presenting symptom of glucagonoma, and early recognition can allow treatment before metastatic spread occurs.
Comment
Hyperpigmented plaques with erosions and fragile blisters, particularly involving the extremities and intertriginous areas, in a patient with worsening type 2 diabetes mellitus should raise concern for necrolytic migratory erythema (NME). Although rare, NME is a characteristic dermatologic manifestation of glucagonoma. In this case, a biopsy of the patient’s pancreatic mass confirmed the diagnosis. Clinicians should remember that NME may be the presenting symptom of glucagonoma, and early recognition can allow treatment before metastatic spread occurs.