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On examination, glossitis and centrifugal growth erosive-scabby lesions in perioral, perineal and perianal area (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B) were identified. Glucagon levels had increased to 619<span class="elsevierStyleHsp" style=""></span>pg/ml (range: 59–177<span class="elsevierStyleHsp" style=""></span>pg/ml). Suspecting necrolytic migratory erythema in the context of glucagonoma, a scintigraphy was performed with somatostatin receptors, observing a pathological uptake in the pancreas. A distal pancreatectomy was performed, confirming the existence of a pancreatic endocrine tumor compatible with glucagonoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B) through histopathology. Hyperglycemia and skin lesions disappeared after surgery. No recurrence was evident after 6 months of follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Glucagonoma syndrome is characterized by the presence of a pancreatic alpha cell tumor associated with diabetes mellitus, weight loss, stomatitis, diarrhea and necrolytic migratory erythema. Necrolytic migratory erythema represents the most specific clinical finding of the syndrome, being present in 67% of cases; it is also one of the first signs of onset, hence the importance of its identification, so that early diagnosis and subsequent treatment can be established for this tumor.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Moreno-Suárez F, Pulpillo-Ruiz Á, Fontillón Alberdi M. Eritema necrolítico migratorio: clave diagnóstica en el síndrome del glucagonoma. Med Clin (Barc). 2017;148:e45.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 492 "Ancho" => 1499 "Tamanyo" => 107231 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 557 "Ancho" => 1500 "Tamanyo" => 211874 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014800000008/v1_201705270058/S2387020617302668/v1_201705270058/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014800000008/v1_201705270058/S2387020617302668/v1_201705270058/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617302668?idApp=UINPBA00004N" ]
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