What are the cutaneous manifestations of pancreatitis?
- Cutaneous manifestations of pancreatitis include Cullen sign, Grey Turner sign, and pancreatic fat necrosis.
- Cullen sign is a hemorrhagic discoloration of the umbilical area caused by intraperitoneal hemorrhage from any cause; one of the more frequent causes is acute hemorrhagic pancreatitis.
- Grey Turner sign is a discoloration of the left flank associated with acute hemorrhagic pancreatitis.
- Acute and chronic pancreatitis and pancreatic carcinoma may also produce pancreatic fat necrosis, which presents as very tender, erythematous nodules of the subcutaneous fat that may spontaneously drain necrotic material.
- Patients also often have associated acute arthritis that may be crippling. Histologically, pancreatic fat necrosis demonstrates diagnostic changes manifesting as necrosis and saponification of the fat associated with acute inflammation.
- The fat necrosis is thought to be due to release of lipase and amylase, which have been demonstrated to be elevated within lesions.
