Pancreatic carcinoma presented with panniculitis and polyarthritis: A rare case

Extrapancreatic manifestations can complicate pancreatic disorders. Pancreatic panniculitis, characterized by subcutaneous fat necrosis, develops in 0.3%-3% of patients with pancreatic disorders. Occasionally, pancreatic panniculitis and polyarthritis occur in the same patient with pancreatic diseases, a rare symptomatic triad known as pancreatitis, panniculitis, and polyarthritis (PPP) syndrome. PPP syndrome is primarily caused by acute or chronic pancreatitis and pancreatic carcinoma. Almost half of the patients with PPP syndrome do not present with gastrointestinal signs, which may lead to a delayed diagnosis of underlying pancreatic disease. The skin and arthritic symptoms may be mistaken for rheumatic diseases. The histological finding of skin lesions is a valuable clue for diagnosing pancreatic diseases. Due to the high mortality rate when PPP syndrome is associated with pancreatic carcinoma, we highlight that the pancreas should be thoroughly examined if a skin biopsy indicates pancreatic panniculitis.