Glucagonoma
A rare neuroendocrine tumor of the pancreatic alpha cells that secretes excess glucagon. It leads to a distinct constellation of symptoms, most notably a pathognomonic skin rash.
The “4 Ds” of Glucagonoma
- Dermatitis (Necrolytic Migratory Erythema): The hallmark skin lesion.
- Diabetes: Mild to moderate hyperglycemia due to glucagon-induced glycogenolysis and gluconeogenesis.
- Deep Venous Thrombosis (DVT): Increased risk of thromboembolism.
- Depression/Weight Loss: Systemic symptoms common in chronic malignancy.
Necrolytic Migratory Erythema (NME)
| Feature | Description |
|---|---|
| Morphology | Erythematous, scaly plaques with central clearing and crusting/blistering. |
| Distribution | Perioral, perineal, and intertriginous areas. |
High-Yield Exam Pearl:
- Diagnosis: Confirmed by markedly elevated plasma glucagon levels.
- Association: Always consider neuroendocrine tumors in patients presenting with new-onset diabetes and a strange, migrating, erythematous rash.