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A waxing and waning skin rash
  1. M Echenique-Elizondo,
  2. S de D Jorge
  1. Basque Country University School of Medicine, San Sebastián, Spain
  1. Correspondence to:
    Professor M Echenique-Elizondo
    Basque Country University, School of Medicine, Paseo Dr Beguiristain, 105, 20014 San Sebastián, Spain;

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Clinical presentation

A 72 year old Caucasian female attended the Department of Dermatology with an 11 year history of elevated blood sugar (145 mg/dl) (fig 1). A computerised tomogram was performed (see fig 2). The patient was scheduled for surgery, and a distal pancreatectomy and splenectomy were performed. Examination of the rest of the abdomen was normal. The patient is free of disease after 24 month of follow up and dermal changes cleared seven days after surgery.

Figure 2

 Computerised tomography of the abdomen.


What does computerised tomograpy show and how does it explain the longstanding rash?
See page 1451for answer

This case is submitted by:


  • Robin Spiller, Editor

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