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Treatment: If a pancreatic or liver tumor is identified and able to be surgically excised, the skin lesions may normalize for an extended period of time, but because these tumors metastasize (spread to other areas of the body) quickly, surgery is not curative. In cases of end stage liver disease, surgery is not possible, and the goal of therapy is to increase quality of life and decrease uncomfortable skin lesions with supportive care and addressing the nutritional abnormalities. Supportive care includes supplementing protein and necessary minerals and enzymes through the diet and oral supplements or by weekly intravenous amino acid infusions that are performed in the hospital on an outpatient basis until improvement in the skin is noted. Unfortunately, despite the supportive care, the disease will progress.

The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries . The hepatic portal vein delivers approximately 75% of the liver's blood supply, and carries venous blood drained from the spleen , gastrointestinal tract , and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow . Oxygen is provided from both sources; approximately half of the liver's oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries. [37]

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Mono steroid treatment

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