Insulin
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Insulin Exacerbation of psoriasis: case report A 52-year-old woman experienced exacerbation of psoriasis while receiving insulin for type 2 diabetes mellitus. The woman presented with a 1-year history of a pruritic erythematous plaque on her abdomen. During a clinical trial 1 year earlier, she had received a SC abdominal injection with isophane protamine biosynthetic human insulin [Novolin 30R; dosage not stated]. One month after the treatment, she had noticed erythema at the injection site. The treatment had been continued and, at the end of the 3-month trial, the erythema had coalesced into a 20 × 18cm irregular, erythematous, scaling plaque, with a well-defined periphery. In addition to the abdominal lesions, she had scaling erythematous plaques on her elbows and buttocks, which had been present for 5 years without progression. Histological analysis of an abdominal lesion revealed typical features of psoriasis, following which a diagnosis was made. Subcutaneous injections of Novolin 30R 15 IU twice daily were administered to the left normal part of the abdominal skin for 3 days, with distilled water used as a placebo. Erythema was induced at the injection site 72 hours after restarting Novolin 30R, becoming more remarkable on day 20, and then gradually disappearing. The new lesion eventually resolved after treatment with betamethasone ointment, a year and a half later. Author comment: "[I]n our case, subcutaneous injection of Novolin 30R and not subcutaneous injection alone induced psoriasis at the injection site." Wang P, et al. Subcutaneous injection of isophane protamine biosynthetic human insulin induced psoriasis at the injection site. European Journal of Dermatology 21: 807-808, No. 5, Sep-Oct 2011. Available from: URL: http://dx.doi.org/10.1684/ 803065907 ejd.2011.1479 - China
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Reactions 21 Jan 2012 No. 1385
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