Necrolytic migratory erythema

Necrolytic migratory erythema (NME) is a marker for an alpha-2-glucagon producing islet cell tumor of the pancreas.
Manifested by erythema, vesicle, pustules, bullae, and erosions which involve typically the face and intertriginous areas, in particular the groins, it also involves the shins, ankles feet, and fingertips. The vesicles are often very superficial and tend to become confluent. Brownish red papules may be scattered over much of the skin surface.
Associated abnormalities include a glossitis, stomatitis, dystrophic nails, alopecia, weight loss, anemia, and diabetes.
Although it can occur in patients with hepatic cirrhosis, pancreatitis or celiac sprue, most patients have a pancreatic tumor of the glucagon producing type.

Treatment:

• Resection of the tumor clears the eruption, sometimes within 48 hours.
• Infusion of amino acids has been reported to clear the dermatitis, as has somatostatin or dacarbazine.

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