10th July 2023

A 48-year-old man came into A&E with a new painful and pruritus rash affecting his groin, buttocks, and lower limbs

A 48-year-old man came into A&E with a new painful and pruritus rash affecting his groin, buttocks, and lower limbs (see image below). The lesions appear to be ring-shaped with areas of erosions and blistering. He was also noted to have a ‘sore mouth’ with cracked, dry lips. Upon further questioning, the patient reveals that he has lost 5kg over the last 3 months and was diagnosed with a deep venous thrombosis 3 weeks ago, for which he is now anticoagulated. You suspect his rash is necrolytic migratory erythema.

Which malignancy is this skin manifestation most associated with?

Painful and pruritus rash

Select the SINGLE most appropriate option from the list below. Select ONE option only.