Abstract illustration of inflamed skin folds, representing mucosal and intertriginous erosive dermatitis.

Beyond NME: Understanding Mucosal and Intertriginous Erosive Dermatitis

Soraya Malik in Health & Wellness June 2025 • 4 min read.

"Is Necrolytic Migratory Erythema a Misnomer? Exploring a More Accurate Diagnosis for Glucagonoma-Related Skin Conditions"

In dermatology, clarity in naming conditions is crucial for accurate diagnosis and effective treatment. However, some long-standing names can be misleading, potentially causing delays in proper care. One such case is necrolytic migratory erythema (NME), a skin condition strongly associated with glucagonoma, a rare tumor of the pancreas.

Traditional understanding suggests NME is a distinct entity directly caused by glucagonoma. However, recent research and clinical observations propose that the term 'necrolytic migratory erythema' might be a misnomer. The argument is that it does not fully capture the unique characteristics and locations of the skin lesions, potentially leading to delayed or misdirected diagnoses.

This article explores why some experts advocate for a more descriptive and accurate term: mucosal and intertriginous erosive dermatitis. We will delve into the defining features of this condition, its connection to glucagonoma, and why a shift in terminology could lead to earlier detection and better outcomes for affected individuals. Understanding the nuances of this condition is essential for healthcare professionals and anyone seeking clarity on glucagonoma-related skin manifestations.

Why 'Necrolytic Migratory Erythema' May Be Misleading?

Abstract illustration of inflamed skin folds, representing mucosal and intertriginous erosive dermatitis.

The term 'necrolytic migratory erythema' highlights two key features: necrolysis (skin cell death) and migration (the lesions moving or spreading). While these characteristics can be present, they don't always accurately represent the most consistent and prominent aspects of the skin condition associated with glucagonoma. Here's why:

The term "Necrolytic Migratory Erythema (NME)" is misleading for the following reasons:

Not Always Migratory: The lesions don't always 'migrate' in the classic sense of rapid movement across the skin. Instead, they often appear in specific areas and may persist or slowly expand over time.
Necrolysis Is Variable: While skin cell death (necrolysis) can occur, it's not always the dominant or most striking feature upon microscopic examination (histology). Other changes, like inflammation and skin thickening, might be more prominent.
Location Matters: The name doesn't emphasize the crucial predilection for mucosal surfaces (like the mouth and genitals) and intertriginous areas (skin folds). These locations are highly characteristic and should be a key diagnostic clue.

By overemphasizing less consistent features and neglecting key locations, the term 'necrolytic migratory erythema' can inadvertently lead clinicians to consider other conditions first, delaying the recognition of glucagonoma as the underlying cause.

The Case for Change: A More Accurate Name

Given the limitations of the traditional name, experts propose 'mucosal and intertriginous erosive dermatitis' as a more accurate descriptor. This term emphasizes the key features that are most consistently observed in glucagonoma-related skin conditions: involvement of mucosal surfaces, occurrence in skin folds, and the presence of erosion and inflammation. By focusing on these defining characteristics, the hope is to raise awareness among clinicians and improve early detection rates.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2310/7750.2011.10134, Alternate LINK

Title: Is Necrolytic Migratory Erythema Due To Glucagonoma A Misnomer? A More Apt Name Might Be Mucosal And Intertriginous Erosive Dermatitis

Subject: Dermatology

Journal: Journal of Cutaneous Medicine and Surgery

Publisher: SAGE Publications

Authors: Parbeer Grewal, Thomas G. Salopek

Published: 2012-03-01

Everything You Need To Know

What is Necrolytic Migratory Erythema (NME), and why is it considered a potentially misleading term in dermatology?

Necrolytic Migratory Erythema (NME) is a skin condition traditionally associated with glucagonoma, a rare pancreatic tumor. The term is considered misleading because it emphasizes necrolysis (skin cell death) and migration of lesions, which are not always the most prominent or consistent features. The lesions do not always migrate rapidly, necrolysis isn't always the dominant histological feature, and the term neglects the characteristic involvement of mucosal surfaces and intertriginous areas, potentially delaying accurate diagnosis.

Why is 'mucosal and intertriginous erosive dermatitis' suggested as a more accurate term than 'necrolytic migratory erythema'?

'Mucosal and intertriginous erosive dermatitis' is proposed as a more accurate term because it highlights the key, consistent features of the skin condition associated with glucagonoma. It emphasizes the involvement of mucosal surfaces (like the mouth and genitals), occurrence in skin folds (intertriginous areas), and the presence of erosion and inflammation. This focus aims to improve early detection by drawing attention to the most reliable clinical signs.

How does the location of skin lesions play a critical role in diagnosing glucagonoma-related skin conditions?

The location of skin lesions is a crucial diagnostic clue because glucagonoma-related skin conditions frequently manifest on mucosal surfaces and in intertriginous areas. The traditional term 'necrolytic migratory erythema' doesn't emphasize these locations, which can lead clinicians to overlook glucagonoma as a potential underlying cause. Recognizing the predilection for mucosal and intertriginous areas can prompt earlier investigation for glucagonoma.

What are the potential implications of misdiagnosing or delaying the diagnosis of glucagonoma-related skin conditions due to the use of the term 'necrolytic migratory erythema'?

Misdiagnosing or delaying the diagnosis of glucagonoma-related skin conditions, because of the term 'necrolytic migratory erythema', can have significant implications. Since the skin condition is often a manifestation of an underlying glucagonoma, a delay in diagnosis can postpone treatment of the tumor itself. This delay can lead to disease progression, increased morbidity, and potentially decreased survival rates. Earlier and more accurate diagnosis is essential for timely intervention and improved patient outcomes.

Beyond the name, what other factors contribute to the challenges in diagnosing skin conditions related to glucagonoma, and what advancements are being made to address these challenges?

Besides the misleading name 'necrolytic migratory erythema', challenges in diagnosing skin conditions related to glucagonoma stem from the rarity of glucagonoma itself and the variability in lesion presentation. The absence of rapid migration, variable necrolysis, and unfamiliarity with the condition can cause diagnostic delays. Advancements include increased awareness among dermatologists and endocrinologists about the importance of considering mucosal and intertriginous involvement, promoting thorough skin examinations in patients with suspected glucagonoma, and developing diagnostic algorithms that prioritize key clinical features to improve recognition and prompt further investigation.