P. Gandhi, Senior Resident in Medicine
H. R. Choudhary, Associate Professor of Medicine
R. C. Gupta, Professor of Medicine
R. Jain, Asst. Professor of Medicine
A. Ojha, Senior Resident in Medicine
– J. L. N. Medical College & Associate Group of Hospitals, Ajmer, Rajasthan.
Source: Indian Medical Gazette, CXXXVII (3), 82-86.
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- Insulin therapy:1,2,3,4Cutaneous complications are now uncommon due to increased use of human insulin. Allergic reactions to insulin may be immediate or delayed. Local reactions include, erythema, pruritus, oedema, induration, urticaria and subcutaneous nodules. Localized induration, alteration and scar formation, cutaneous abscess formation and development of keloids may result from faulty injection techniques.
- Lipoatrophy occurs at the site of injection and present as circumscribed atrophic plaques with loss of subcutaneous fat. It is believed to be due to local immune reactions to injected insulin and from local PH and tissue reactivity. It may disappear when sites of injection are rotated.
- Lipohypertrophy produces overgrowth of fat and presents as a soft dermal nodules with overlying skin normal, at the site of injection. It is due to lipogenic action of insulin.
- Oral hypoglycaemic agents:1,2,3,4The cutaneous complications are uncommon and usually develop in the first two months of treatment. They may be phototoxic or allergic in nature. Allergic reactions include maculopapular rash, urticaria, erythema multiforme, Steven Johnson syndrome, erythema nodosum, purpura, and generalized hypersensitivity reactions. Facial flushing has been observed following ingestion of alcohol in patient receiving chlorpropamides.
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- Macaron C., Winter R. J., Traisman H. S., et al – Vitiligo and juvenile diabetes mellitus. Arch Dermatol; 113: 1515, 1977.
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