Severe deterioration of psoriasis due to an insulinoma.
We report a case of a 56-year-old woman who presented with a severe exacerbation of psoriasis with concurrent hypoglycaemic episodes. Methotrexate 17.5 mg weekly was required to control her psoriasis. Investigation of her hypoglycaemia showed raised levels of insulin, C-peptide and proinsulin. Radiological investigation showed a tumour at the tail of the pancreas and the diagnosis was insulinoma. A spleen-preserving distal pancreatectomy was performed and the hypoglycaemic symptoms resolved. Immediately following the pancreatectomy, methotrexate was stopped and the patient's psoriasis went into remission. During a 2-year follow-up, she has required only minimal topical treatment for her skin.
Field
S
S
Department of Dermatology, The Adelaide and Meath Hospital Incorporating the National Children's Hospital, Dublin, Ireland. sineadfield@hotmail.com
Kelly
G
G
Tobin
A-M
AM
Barragry
J M
JM
Conlon
K C
KC
Kirby
B
B
D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007340:Insulinoma / Q000150:complications* / Q000601:surgery; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods; D010187:Pancreatic Hormones / Q000378:metabolism; D011565:Psoriasis / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
D010187:Pancreatic Hormones