Pancreatic panniculitis is characterized by the pathognomic histopathologic finding showing lobular panniculitis with focal fat necrosis and ghost-like cells. It appears in 2~3% of all patients with pancreatic diseases and occasionally associated with polyarthritis. This triad is known as the pancreatitis, panniculitis, and polyarthritis (PPP) syndrome. Although, several cases of pancreatic panniculitis were presented in the Korean dermatologic literature, PPP syndrome has not been reported. A 69-year-old man was referred to our clinic with multiple erythematous painful subcutaneous nodules on his both lower legs. He was under the care of hospice for end-stage pancreatic acinar cell carcinoma. His serum lipase level was markedly elevated. Incisional biopsy was performed, and histopathologic finding was consistent with pancreatic panniculitis. After five weeks, he developed pain and marked swelling involving hands, knees and ankles. The radiographic finding of both hands showed multifocal osteolysis. Consequently, the diagnosis of PPP syndrome was made based on the clinical, radiologic and pathologic findings. Herein, we report the first case of PPP syndrome in the Korean dermatologic literature. PPP syndrome should be suspected in pancreatic cancer patients with dermatologic and arthritic symptom.