Arthritis and Skin Lesions Resembling Erythema Nodosum in Pancreatic Disease

Publisher Website
Google Scholar
Abstract
The clinical association of subcutaneous fat necrosis, acute synovitis and subcutaneous nodules present in some patients with pancreatitis or carcinoma of the pancreas may mimic erythema nodosum. Predominant severe polyarthritis secondary to para-articular fat necrosis or relatively frequent great toe involvement may make this clinical symptom complex difficult to distinguish from a generalized connective tissue disorder or gouty arthritis. Eosinophilia of 5 to 21% is frequently noted when subcutaneous fat necrosis accompanies carcinoma of the pancreas. Definitive diagnosis of subcutaneous or periarticular fat necrosis by skin or soft tissue biopsy was frequently recorded among the 36 patients. Unusual subcutaneous nodules often appearing in successive crops and exhibiting a diffuse distribution (buttocks, trunk, back and even scalp) associated with signs of active synovitis should alert the clinician to the possibility of occult or unconsidered pancreatic disease.