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Year : 2007  |  Volume : 73  |  Issue : 6  |  Page : 446

Symmetrical erythematous annular and scaly patches

Department of Dermatology, Medical College, Calicut, India

Correspondence Address:
Najeeba Riyaz
Arakkal Chalapuram, Calicut - 673002, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0378-6323.37083

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How to cite this article:
Riyaz N, Rajan U, Anuradha K B. Symmetrical erythematous annular and scaly patches. Indian J Dermatol Venereol Leprol 2007;73:446

How to cite this URL:
Riyaz N, Rajan U, Anuradha K B. Symmetrical erythematous annular and scaly patches. Indian J Dermatol Venereol Leprol [serial online] 2007 [cited 2021 Jan 24];73:446. Available from:

A 52 year-old woman presented with a two-year history of pruritic, burning and expanding red rings involving the entire body. She had marked fatigue, anorexia and weight loss. Examination revealed a cachectic woman with symmetrical erythematous annular and scaly patches involving the trunk [Figure - 1], lower limbs and back. A few pustules and vesicles were present on the trunk. Intertriginous areas showed erosions. Glossitis and stomatitis were also present.

Investigations revealed a hemoglobin (Hb) value of 7.5 gm%, hyperglycemia (postprandial blood sugar, PPBS = 320 mg%), abnormal glucose tolerance test results and aminoaciduria. Skin biopsy showed intraepidermal cleft, vacuolated pale epidermal cells with pyknotic nuclei and neutrophils in the upper epidermis [Figure - 2].

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1.Sweet RD. A dermatosis specifically associated with tumour of pancreatic alpha cells. Br J Dermatol 1974;90:301-8.  Back to cited text no. 1  [PUBMED]    
2.Wilkinson DS. Necrolytic migratory erythema with pancreatic carcinoma. Proc R Soc Med 1971;64:1197-8.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  
3.Marinkovich MP, Botella R, Datloff J, Sangueza OP. Necrolytic migratory erythema without glucagonoma in patients with liver disease. J Am Acad Dermatol 1995;32:605-9.  Back to cited text no. 3      
4.Blacford S, Wright S, Roberts DL. Necrolytic migratory erythema without glucagonoma: The role of dietary essential fatty acids. Br J Dermatol 1991;125:460-2.  Back to cited text no. 4      
5.Kelly CP, Johnson CF, Nolan N, Keeling PW, Weir DG. Necrolytic migratory erythema with elevated plasma enteroglucagon in celiac disease. Gastroenterology 1989;96:1350-3.  Back to cited text no. 5      
6.Mullans EA, Cohen PR. Iatrogenic necrolytic migratory erythema. A case report and review of non-glucagonoma associated necrolytic migratory erythema. J Am Acad Dermatol 1998;38:866-73.  Back to cited text no. 6      
7.Peterson LL, Shaw JC, Acott KM, Mueggler PA, Parker F. Glucagonoma syndrome: In vitro evidence that glucagon increases epidermal arachidonic acid. J Am Acad Dermatol 1984;11:468-73.  Back to cited text no. 7  [PUBMED]    
8.Bewly AP, Ross JS, Bunker CB, Staughton RC. Successful treatment of a patient with octreotide-resistant necrolytic migratory erythema. Br J Dermatol 1996;134:1101-4.  Back to cited text no. 8      
9.van der Loos TL, Lambrecht ER, Lambers JC. Successful treatment of glucagonoma related necrolytic migratory erythema with dacarbazine. J Am Acad Dermatol 1987;16:468-72.  Back to cited text no. 9  [PUBMED]    


  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]


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