title: Glucagon therapy as a possible cause of erythema necrolyticum migrans in two neonates with persistent hyperinsulinaemic hypoglycaemia.
abstract: 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.
authors.affiliation: University Children's Hospital, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Wald
authors.forename: Karin
authors.initials: K
authors.lastname: Lawrenz
authors.forename: Doris
authors.initials: D
authors.lastname: Luckner
authors.forename: Richard
authors.initials: R
authors.lastname: Seimann
authors.forename: Klaus
authors.initials: K
authors.lastname: Mohnike
authors.forename: Edith
authors.initials: E
authors.lastname: Schober
mesh_terms: 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
chemical_list: D005934:Glucagon