A Case of Pancreatitis, Panniculitis, and Polyarthritis Syndrome in Pancreatic Acinar Cell Carcinoma

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a rare triad driven by an underlying pancreatic pathology that releases high levels of pancreatic enzymes into systemic circulation. We describe a patient who presented with erythematous skin nodules, painful swelling of multiple joints, and vague abdominal symptoms who was ultimately diagnosed with metastatic pancreatic acinar cell carcinoma. Early diagnosis of PPP syndrome remains challenging because rheumatologic findings often overshadow gastrointestinal symptoms. Timely diagnosis is crucial, because treatment of the underlying pancreatic disease improves symptoms and minimizes long-term complications.