Glucagon therapy as a possible cause of erythema necrolyticum migrans in two neonates with persistent hyperinsulinaemic hypoglycaemia.
Erythema necrolyticum migrans (ENM) usually presents as a cutaneous paraneoplastic phenomenon which is in most cases associated with a glucagon-producing tumour. Here it is for the first time described as a side-effect of glucagon treatment in persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI). In both patients, the skin lesions disappeared after discontinuation of glucagon administration. In the first child the erythema resolved without scarring within 10 days after glucagon was substituted with other medication while in the second patient healing followed subtotal pancreatectomy which rendered glucagon infusion unnecessary. Initially the clinical resemblance to atopic dermatitis is prone to cause diagnostic errors, especially in this age group.


CONCLUSIONS
erythema necrolyticum migrans should be considered as a differential diagnosis in patients who develop erythematosquamous skin lesions under glucagon treatment.
Wald
Martin
M
University Children's Hospital, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Lawrenz
Karin
K
Luckner
Doris
D
Seimann
Richard
R
Mohnike
Klaus
K
Schober
Edith
E
D004200:Diseases in Twins; D004890:Erythema / Q000139:chemically induced*; D005260:Female; D005934:Glucagon / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006946:Hyperinsulinism / Q000188:drug therapy*; D007003:Hypoglycemia / Q000209:etiology; D007231:Infant, Newborn
D005934:Glucagon