Necrolytic Migratory Erythema
Cary Chisholm, MD
Key Facts
Terminology
-
Skin manifestation of glucagonoma syndrome
Clinical Issues
-
Trunk, groin, extremities, thighs, and buttocks are most frequently involved
-
Annular or round erythematous or violaceous patches
-
Vesicle or bulla formation with crusting after rupture
-
Self-limited: Typically resolves within 2 weeks
-
Age > 40 years (age distribution of glucagonoma)
Microscopic Pathology
-
Pale keratinocytes in upper epidermis with clear vacuoles and confluent parakeratosis
-
± necrosis, psoriasiform hyperplasia, spongiosis
-
Significant necrosis may produce subcorneal or intraepidermal clefting
-
May form neutrophilic pustules
-
Usually a superficial perivascular lymphocytic infiltrate ± neutrophils
NME shows confluent erythema  with circinate borders  and erosions  at the site of rupture of flaccid bullae. (Courtesy PMPH-USA Publishing and the Univ. of Utah Dept. of Dermatology.) |
The most characteristic feature of necrolytic migratory erythema is pale, vacuolated keratinocytes within the superficial epidermis  . (Courtesy S. Billings, MD.) |
TERMINOLOGY
Abbreviations
-
Necrolytic migratory erythema (NME)
Definitions
-
Skin manifestation of glucagonoma syndrome
-
Glucagon-secreting neuroendocrine tumor of pancreas
-
a.k.a. islet cell tumor
-
-
Presenting symptom of glucagonoma syndrome in 70% of cases
-
-
Has been reported in other conditions
-
Other pancreatic neuroendocrine tumors
Stay updated, free articles. Join our Telegram channel
-
Full access? Get Clinical Tree
