Necrotizing panniculitis: a skin condition associated with acinar cell carcinoma of the pancreas.

Pancreatic panniculitis (PP) is a rare cutaneous eruption that is associated with severe pancreatic disease. A patient presented with a fever, joint pains, and an erythematous rash with draining pustules that had spread from his legs to his arms over 4 months. Thorough investigation revealed stage IV acinar cell carcinoma of the pancreas. The rash was a result of necrotizing PP. The variable cutaneous manifestations of internal malignancies may challenge primary care physicians and dermatologists when patients present without findings associated with malignancy. Panniculitis should be kept in mind in the differential diagnosis of inflamed appearing nodules and pustules with an erythematous base, particularly when they are progressive and unrelenting.