Necrolytic migratory erythema: a classical cutaneous presentation of the glucagonoma syndrome

We report a case of necrolytic migratory erythema secondary to an underlying pancreatic glucagonoma causing the glucagonoma syndrome. We discuss the differential diagnosis of necrolytic migratory erythema and the importance of recognising this rare endocrine tumour with its marked cutaneous features. Patients with glucagonoma syndrome can present late in a debilitated state and often require much nutritional support. Treatment with a new long-acting somatostatin analogue, Lanreotide (Somatuline S.R.) 30 mg once weekly, has in our case so far produced encouraging results. We would like to emphasise the importance of the insidious onset of this syndrome and the high incidence of metastatic disease at presentation.