Total pancreatectomy in a patient with a dermadrome caused by intraductal papillary mucinous neoplasm: A case report

TL;DR

An 83-year-old woman with a skin rash caused by a rare pancreatic tumor showed improvement after total pancreatectomy, suggesting a new link between the tumor and the rash.

Contribution

This is the first reported case of a dermadrome caused by IPMN that resolved after total pancreatectomy.

Findings

The patient's skin rash improved after total pancreatectomy.

Histopathology confirmed high-grade dysplasia in the IPMN.

The rash was identified as a dermadrome caused by IPMN.

Abstract

Dermadrome is a term coined by combining the words “dermatology” and “syndrome,” and it refers to dermatological symptoms that reflect visceral lesions.

Herein, we present the case of an 83-year-old female patient who presented with generalized blistering and erythema during treatment for acute pancreatitis. She was referred to our dermatology department with worsening erythema, although the acute pancreatitis improved. The cause of the erythema was suspected to be drug-induced, infectious, or related to collagen disease; however, the exact cause was unknown. Computed tomography and endoscopic ultrasonography findings revealed a mixed-type intraductal papillary mucinous neoplasm (IPMN). Refractory erythema was suspected to have been caused by a dermadrome due to IPMN. Consequently, she was referred to our department. The main pancreatic duct was dilated along its entire length, and tumor extension was difficult to determine; therefore, a total pancreatectomy was performed. The postoperative course was uneventful, and erythema gradually improved. The histopathological evaluation indicated high-grade dysplasia of the IPMN.

The patient's skin rash, which did not improve with treatment that included high-dose steroids, began to improve after surgery, and the disease was thought to be a dermadrome caused by IPMN.

We believe that this is the first reported case of IPMN with a dermadrome that resolved after a total pancreatectomy.

•An 83-year-old female patient presented with generalized blistering and erythema.•The patient's skin rash improved after surgery.•The disease was identified as a dermadrome caused by IPMN.•This is the first reported case of IPMN with a dermadrome that resolved after a total pancreatectomy.

An 83-year-old female patient presented with generalized blistering and erythema.

The patient's skin rash improved after surgery.

The disease was identified as a dermadrome caused by IPMN.

This is the first reported case of IPMN with a dermadrome that resolved after a total pancreatectomy.

Figures