Which cutaneous manifestations are associated with complications of DM treatment

Treatment with insulin can cause local or systemic allergic reactions (itching, urticaria, seldom angioneurotic oedema, etc.); however, these are now extremely rare due to the use of the purified human insulins that are available. Lipoatrophy (localized loss of subcutaneous tissue) or lipohypertrophy (increase/thickening of subcutaneous tissue) at sites of insulin injection are also relatively rare today with the new insulins.

Oral antidiabetic medicines, and mainly sulfonylureas, may also cause allergic reactions from the skin, within 6-8 weeks from onset of

Figure 18.6. Erythema multiforme with the typical target lesions (Reprinted from Color Atlas of Dermatology, G.M. Levene, Copyright 1974, with permission from Elsevier).

treatment. These range from the simple urticaria to erythema multiforme (Figure 18.6) and its severe form (Stevens Johnson syndrome, see Figure 18.7), as well as eczema, blisters in the skin, photosensitivity, purpura and erythema nodosum.

Figure 18.7. Mouth ulcerations in Stevens-Johnson syndrome, the severe form of erythema multiforme (Reprinted from Color Atlas of Dermatology, G.M. Levene, Copyright 1974, with permission from Elsevier).
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