Necrolytic Migratory Erythema

  • Liam Zakko
  • Justin Finch
  • Marti J. Rothe
  • Jane M. Grant-Kels


Clinical signs and features include:

Rare dermatitis that occurs mostly in patients with α-cell tumor of the pancreas (glucagonoma) that usually occurs in the fifth to sixth decade and presents with frequency of 1:20,000,000 persons/year

Rash comes in waves of irregular erythematous lesions with visible scale with subsequent necrosis and crusting of the epidermis in the center of the lesions leading to bullae

Central healing ultimately occurs giving the lesions an annular appearance; the process for development to healing is about 2 weeks

Predilection for intertriginous sites and areas subject to pressure and frictions (e.g., perineum, groin, buttocks, lower abdomen, and lower extremities)


Vasoactive Intestinal Polypeptide Fatty Acid Level Erythema Multiforme Migratory Erythema Normocytic Anemia 
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  1. 1.
    Chastain MA. The glucagonoma syndrome: a review of its features and a discussion of its perspectives. Am J Med Sci. 2001;321:306–20.PubMedCrossRefGoogle Scholar
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    Fedeles F, Murphy M, Rothe MJ, Grant-Kels JM. Nutrition and bullous skin disease. Clin Dermatol. 2010;28:627–43.PubMedCrossRefGoogle Scholar
  3. 3.
    van Beek AP, de Haas ER, van Vloten WA, et al. The glucagonoma syndrome and necrolytic migratory erythema: a clinical review. Eur J Endocrinol. 2004;157:531–7.CrossRefGoogle Scholar
  4. 4.
    Otto AI, Marshalks M, Zalatnai A, et al. Glucagon cell adenomatosis: a new entity associated with necrolytic migratory erythema and glucagonoma syndrome. J Am Acad Dermatol. 2011;65:458–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Liam Zakko
    • 1
  • Justin Finch
    • 2
  • Marti J. Rothe
    • 2
  • Jane M. Grant-Kels
    • 2
  1. 1.Yale Department of Internal MedicineYale New Haven HospitalNew HavenUSA
  2. 2.Department of DermatologyUniversity of Connecticut Health CenterFarmingtonUSA

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