Apoptosis with positive direct immunofluorescence findings in a patient with necrolytic migratory erythema.
A 45-year-old man with a glucagonoma and necrolytic migratory erythema is described. Clinical, radiographic, and histologic features were typical for this syndrome. However, a skin biopsy specimen for direct immunofluorescence examination revealed apoptotic keratinocytes that stained positive with immunoglobulins, fibrinogen, and C3. These immunofluorescence findings were initially interpreted erroneously as showing erythema multiforme or a related disorder. We present a unique case of necrolytic migratory erythema with positive direct immunofluorescence findings reflecting immunoglobulin and complement deposition within dyskeratotic epithelial cells.
Perniciaro
C
C
Department of Dermatology, Mayo Clinic Jacksonville, Florida 32224, USA.
Rappaport
K D
KD
White
J W
JW
D017209:Apoptosis; D003176:Complement C3 / Q000378:metabolism; D004890:Erythema / Q000175:diagnosis* / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D019085:Fluorescent Antibody Technique, Direct; D005935:Glucagonoma / Q000175:diagnosis*; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D015603:Keratinocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D012867:Skin / Q000378:metabolism / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D003176:Complement C3; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D005340:Fibrinogen