Case report of multiple pustules of the bilateral lower limbs caused by a granulocyte colony-stimulating factor-producing solid pseudopapillary tumour of the pancreas

Y. Iwata, T. Kobayashi, M. Kuroda, Y. Mizoguchi, M. Arima, S. Numata, S. Watanabe, Akiko Yagami, K. Matsunaga, Kazumitsu Sugiura

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Abstract

Here we report a rare case of neutrophilic dermatoses related to a granulocyte colony-stimulating factor (G-CSF)-producing solid pseudopapillary tumour (SPT). The patient was a 39-year-old woman presenting with scattered pustules and crusts of the palms, heels and thighs and plaques of the bilateral lower legs. The skin biopsy revealed dense neutrophil infiltration in the epidermis to the dermis. A pancreatic head tumour was detected using computed tomography. A pathological examination of the resected specimen suggested an SPT. As the skin eruption promptly disappeared after SPT resection, we hypothesized that SPT secretes growth factors including epidermal growth factor (EGF) and G-CSF. The SPT cells stained positive for both EGF and G-CSF tumour cells. The serum levels of interleukin (IL)-6 and IL-10 and tumour necrosis factor-α were within normal limits before and after the SPT resection. In contrast, the serum IL-8, EGF and G-CSF levels decreased after the SPT resection. This is a rare case of neutrophilic dermatoses related to a G-CSF-producing SPT. The present case suggests that physicians should be aware that a G-CSF-producing tumour is a differential diagnosis to consider in patients with unusual aseptic pustulosis.

Original languageEnglish
Pages (from-to)1122-1126
Number of pages5
JournalBritish Journal of Dermatology
Volume177
Issue number4
DOIs
Publication statusPublished - 01-10-2017
Externally publishedYes

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Granulocyte Colony-Stimulating Factor
Pancreas
Lower Extremity
Neoplasms
Epidermal Growth Factor
Skin Diseases
Skin
Neutrophil Infiltration
Heel
Dermis
Thigh
Serum
Interleukin-8
Epidermis
Interleukin-10
Interleukin-6
Leg
Intercellular Signaling Peptides and Proteins
Differential Diagnosis
Tumor Necrosis Factor-alpha

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

Iwata, Y. ; Kobayashi, T. ; Kuroda, M. ; Mizoguchi, Y. ; Arima, M. ; Numata, S. ; Watanabe, S. ; Yagami, Akiko ; Matsunaga, K. ; Sugiura, Kazumitsu. / Case report of multiple pustules of the bilateral lower limbs caused by a granulocyte colony-stimulating factor-producing solid pseudopapillary tumour of the pancreas. In: British Journal of Dermatology. 2017 ; Vol. 177, No. 4. pp. 1122-1126.
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abstract = "Here we report a rare case of neutrophilic dermatoses related to a granulocyte colony-stimulating factor (G-CSF)-producing solid pseudopapillary tumour (SPT). The patient was a 39-year-old woman presenting with scattered pustules and crusts of the palms, heels and thighs and plaques of the bilateral lower legs. The skin biopsy revealed dense neutrophil infiltration in the epidermis to the dermis. A pancreatic head tumour was detected using computed tomography. A pathological examination of the resected specimen suggested an SPT. As the skin eruption promptly disappeared after SPT resection, we hypothesized that SPT secretes growth factors including epidermal growth factor (EGF) and G-CSF. The SPT cells stained positive for both EGF and G-CSF tumour cells. The serum levels of interleukin (IL)-6 and IL-10 and tumour necrosis factor-α were within normal limits before and after the SPT resection. In contrast, the serum IL-8, EGF and G-CSF levels decreased after the SPT resection. This is a rare case of neutrophilic dermatoses related to a G-CSF-producing SPT. The present case suggests that physicians should be aware that a G-CSF-producing tumour is a differential diagnosis to consider in patients with unusual aseptic pustulosis.",
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Case report of multiple pustules of the bilateral lower limbs caused by a granulocyte colony-stimulating factor-producing solid pseudopapillary tumour of the pancreas. / Iwata, Y.; Kobayashi, T.; Kuroda, M.; Mizoguchi, Y.; Arima, M.; Numata, S.; Watanabe, S.; Yagami, Akiko; Matsunaga, K.; Sugiura, Kazumitsu.

In: British Journal of Dermatology, Vol. 177, No. 4, 01.10.2017, p. 1122-1126.

Research output: Contribution to journalArticle

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