Abstract
As the incidence and prevalence of Diabetes Mellitus is increasing, more cases of dermatologic complications attributed to therapy are being reported. Injection site reactions, most commonly erythema, edema and induration, lipohypertrophy, and lipoatrophy have been associated with subcutaneous insulin therapy. Accurate diagnosis is important to guide clinical management and to ensure appropriate blood glucose control. Herein, we present an unusual case of bilateral nodules on the thighs secondary to insulin injections.
Highlights
As the incidence and prevalence of diabetes mellitus is increasing, more cases of dermatologic complications attributed to therapy are being reported
In view of the clinical history and histopathologic findings, the patient was diagnosed with a palisaded granulomatous reaction induced by insulin injections
More cases of dermatologic complications attributed to insulin therapy are being reported with the concurrent increase in diabetes mellitus[1,2]
Summary
As the incidence and prevalence of diabetes mellitus is increasing, more cases of dermatologic complications attributed to therapy are being reported. We present an unusual case of bilateral nodules on the thighs secondary to insulin injections. Nodules located on her proximal lateral thighs where insulin injections were repeatedly administered. Histopathologic evaluation revealed a patchy dense inflammatory infiltrate composed of lymphocytes, plasma cells, eosinophils and irregular aggregates of mono- and multinucleated histiocytes surrounding areas of degenerated hyalinized collagen bundles. This process involved the full thickness of the dermis (Figure 2). In view of the clinical history and histopathologic findings, the patient was diagnosed with a palisaded granulomatous reaction induced by insulin injections. At the follow up appointment after rotating multiple other injection sites, she has not developed any other granulomas
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