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.