Endocrine Abstracts

We report a case of 39–year-old female presented with painful, scaling skin lesions on insulin application sites. She was diagnosed with type 1 diabetes mellitus (T1DM) at the age of 21 years and treated with intensified conventional insulin therapy. Three months before hospital admission, she suddenly started to feel pain at insulin injection sites, followed by oval subcutaneous deposits and skin ulcer in the further course. Identical local changes repeated after subcutaneous use of every available type of both human insulin and insulin analog. Patient past medical history was significant for surgically treated cervical cancer, cervical disc herniation and unilateral hip replacement due to femoral head osteonecrosis. On physical examination, multiple skin lesions in a form of scabs with maximal diameter of 7 mm, were present in bilateral upper arm and anterior abdominal region, and along the thighs. Her insulin injection technique was observed and estimated as adequate. Clinical, biochemistry and radiological assessment was performed as the biopsy of skin lesions. An insulin pump was inserted, but after a few days the same changes occurred at the site of catheter application. She is currently being treated with insulin parenterally.