Necrolytic migratory erythema

Glucagon infusions in the treatment of tumor-induced hypoglycemia can cause adverse effects comparable to the effects of a glucagonoma (hyperglycemia, necrolytic migratory erythema, weight loss, anemia, angular cheilitis, and venous thrombosis), as reported in three patients (10). 

A 38-year-old woman developed erythematous dermatitis, in a skin biopsy consistent with necrolytic migratory erythema, and angular cheilitis, which disappeared after withdrawal of glucagon infusion after 2 months. 

Chronic administration of glucagon can cause an eczema-like maculopapular scaly rash, which can progress to necrolytic migratory erythema, as in glucagonoma... 

Glucagonoma syndrome (necrolytic migratory erythema) (1988) Benhamou PY+, Ann Dermatol Venereol (French)... 

Skin Necrolytic migratory erythema has been attributed to methadone [90 ]. 

Necrolytic migratory erythema is usually part of the glucagonoma syndrome, which is characterized by an alpha cell tumor of the pancreas, leading to adult onset diabetes mellitus, weight loss, and glossitis. It is often mistaken for intertrigo or seborrheic dermatitis. Its pathogenesis is not well understood. The role of opiates in this case was not clear, but it was not due to poor nutrition or poor absorption of nutrients. The authors speculated that opiates had had a direct effect on epidermal metabohsm. 

Muller FM, Arseculeratne G, Evans A, Fleming C. Necrolytic migratory erythema in an opiate-dependent patient. Chn Exp Dermatol 2007 33 40-2. 

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