Necrolytic Migratory Erythema (NME / नेक्रोलिटिक माइग्रेटरी एरिथेमा) एक rare dermatological condition है, जो अक्सर Glucagonoma Syndrome के साथ जुड़ी होती है।
- यह एक paraneoplastic skin eruption है।
- Most commonly associated है pancreatic alpha-cell tumor (glucagonoma) के साथ।
- Skin lesions typically erythematous, blistering, and migratory होते हैं।
- Metabolic abnormalities और malnutrition के कारण भी aggravate हो सकते हैं।
Necrolytic Migratory Erythema क्या है (What is Necrolytic Migratory Erythema)
- Rare skin manifestation characterized by:
- Red, blistering, and erosive lesions
- Migratory patches over extremities, perineum, face, and trunk
- Scaling, crusting, and superficial necrosis
- Often associated with glucagon overproduction from pancreatic tumor
- May be accompanied by weight loss, diarrhea, and diabetes mellitus
Necrolytic Migratory Erythema कारण (Causes of Necrolytic Migratory Erythema)
1. Glucagonoma Syndrome
- Most common cause
- Pancreatic alpha-cell tumor → excessive glucagon → metabolic disturbances → skin lesions
2. Nutritional Deficiencies
- Zinc deficiency
- Amino acid deficiency
- Essential fatty acid deficiency
3. Other Contributing Factors
- Diabetes mellitus
- Liver disease
- Chronic inflammation or metabolic stress
Glucagonoma accounts for approximately 70–80% of NME cases।
Necrolytic Migratory Erythema लक्षण (Symptoms of Necrolytic Migratory Erythema)
- Erythematous, scaly, blistering skin lesions
- Lesions migrate over time
- Painful or itchy rash
- Weight loss and muscle wasting
- Mild diabetes mellitus (hyperglycemia)
- Gastrointestinal symptoms: diarrhea, glossitis, stomatitis
- Nail changes: brittle nails
Lesions are often perioral, perineal, and acral (hands and feet)।
Necrolytic Migratory Erythema कैसे पहचाने (Diagnosis of Necrolytic Migratory Erythema)
- Physical Examination – characteristic migrating erythematous patches with crusting
- Blood Tests – elevated glucagon levels, hyperglycemia, anemia, low zinc
- Skin Biopsy – epidermal necrosis, pallor of upper epidermis, superficial perivascular inflammation
- Imaging (CT / MRI) – locate pancreatic tumor
- Additional Labs – amino acid levels, liver function tests
Early diagnosis critical for detecting underlying glucagonoma।
Necrolytic Migratory Erythema इलाज (Treatment of Necrolytic Migratory Erythema)
1. Treat Underlying Glucagonoma
- Surgical resection of pancreatic tumor
- Tumor removal often resolves skin lesions
2. Nutritional Support
- Zinc supplementation
- Amino acids, fatty acids
- High-protein diet
3. Medications
- Somatostatin analogs (Octreotide) to reduce glucagon secretion
- Topical corticosteroids for symptom relief (temporary)
- Pain management and wound care
4. Monitoring
- Blood glucose monitoring
- Follow-up imaging to detect recurrence of tumor
- Regular dermatological evaluation
Treatment targets both underlying tumor and skin manifestations।
रोकथाम (Prevention)
- Early detection of pancreatic tumors
- Manage diabetes and nutritional deficiencies
- Regular check-ups for patients with chronic or recurrent skin eruptions
- Maintain balanced diet with adequate zinc and amino acids
सावधानियाँ (Precautions)
- Do not ignore migratory, blistering skin lesions
- Avoid self-medication with topical steroids for prolonged period
- Monitor for weight loss, fatigue, hyperglycemia
- Follow-up after surgery or treatment to detect recurrence
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. Necrolytic Migratory Erythema क्या contagious है?
नहीं, यह skin manifestation tumor or metabolic disorder के कारण होती है।
Q2. क्या यह सिर्फ skin rash है?
नहीं, यह paraneoplastic syndrome है और अक्सर glucagonoma से जुड़ी होती है।
Q3. Glucagonoma surgery के बाद rash गायब हो जाएगी?
हाँ, tumor removal के बाद अक्सर NME rash resolve हो जाती है।
Q4. कौन high-risk में हैं?
Middle-aged adults, especially with pancreatic alpha-cell tumors और metabolic abnormalities।
निष्कर्ष (Conclusion)
Necrolytic Migratory Erythema (नेक्रोलिटिक माइग्रेटरी एरिथेमा) एक rare dermatological condition है, जो अक्सर glucagonoma syndrome से जुड़ी होती है।
Early detection, surgical tumor removal, nutritional support, और metabolic management से skin lesions और systemic symptoms दोनों improve हो सकते हैं।
अगर किसी को migratory blistering rash, weight loss, या unexplained diabetes हो, तो तुरंत dermatologist और endocrinologist से consultation करना चाहिए।