Differential Diagnosis for Pancreatitis and Yellow-Brown Skin Papules
Single Most Likely Diagnosis
- Hypertriglyceridemia-induced Pancreatitis with Eruptive Xanthomas: This condition is characterized by elevated triglyceride levels leading to pancreatitis and the formation of yellow-brown skin papules known as eruptive xanthomas. The absence of alcohol consumption and the presence of skin papules point towards a lipid disorder.
Other Likely Diagnoses
- Familial Hypercholesterolemia: Although more commonly associated with cholesterol deposits in tendons (tendinous xanthomas) and cardiovascular disease, familial hypercholesterolemia can also lead to pancreatitis if triglyceride levels are significantly elevated. The skin papules could be consistent with this diagnosis if they are actually xanthomas.
- Chronic Pancreatitis due to Genetic Mutations (e.g., PRSS1, SPINK1): Certain genetic mutations can lead to chronic pancreatitis, and while less directly linked to skin papules, the combination of pancreatitis and skin findings could be part of a broader syndrome.
Do Not Miss Diagnoses
- Porphyrias (especially Porphyria Cutanea Tarda): While porphyrias are rare, they can cause skin blistering and fragility, and some forms can lead to neurological symptoms and abdominal pain that might mimic pancreatitis. The skin findings could be confused with xanthomas, making this a critical diagnosis not to miss.
- Malignancy (e.g., Pancreatic Cancer with Metastatic Skin Deposits): Although rare in a 20-year-old, pancreatic cancer can cause pancreatitis and skin metastases. This diagnosis is crucial not to miss due to its severe implications.
Rare Diagnoses
- Tangier Disease: A rare genetic disorder characterized by very low levels of HDL cholesterol and the accumulation of cholesterol in various tissues, potentially leading to pancreatitis and skin manifestations.
- Lipodystrophy Syndromes: These are a group of rare disorders characterized by the selective loss of body fat, which can lead to metabolic disturbances including hypertriglyceridemia, pancreatitis, and potentially skin manifestations like xanthomas.