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Multiple subcutaneous angiolipomas associated with new‐onset diabetes mellitus
Author(s) -
Levitt Jacob,
Lutfi Ali Suad A.,
Sapadin Allen
Publication year - 2002
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.2002.01445.x
Subject(s) - medicine , diabetes mellitus , family history , type 2 diabetes mellitus , physical examination , medical history , past medical history , surgery , stroke (engine) , microangiopathy , body mass index , histopathology , pediatrics , pathology , endocrinology , mechanical engineering , engineering
A 44‐year‐old Hispanic man, with a past medical history of diabetes mellitus type 2 and cerebrovascular accident, presented to the Mount Sinai Department of Dermatology with sudden, fast‐growing nodules over both of his shins. Approximately 2 months before the appearance of the nodules, the patient was diagnosed with diabetes mellitus type 2 with hemoglobin A 1c (HbA 1c ) of 8.5%. The patient was taking metformin orally, 500 mg three times daily, at the time of presentation. Six nodules appeared over a period of days. They caused a burning, throbbing pain upon ambulation. Over a period of 6 months, the lumps decreased in size, and two totally disappeared. The resolution of the nodules coincided with the control of the patient's diabetes, as demonstrated by HbA 1c of 5.5%. The patient denied trauma to the sites of the nodules. The patient denied any associated purpura or ecchymoses over the nodules. The past medical history was significant for a stroke with residual right hemiparesis at 42 years of age. The family history was negative for similar lesions, but an aunt did have diabetes mellitus type 2. The patient denied alcohol use, smoking, or intravenous drug use. Physical examination was positive for six soft, tender, freely mobile, symmetrical, well‐demarcated, round masses, 1–2 cm in diameter and skin colored, over the anterior aspects of both legs. The patient was obese (body mass index, 38.5). Laboratory tests (barring the initially elevated HbA 1c ) were normal. One lesion was excised. Histopathology revealed features typical of an angiolipoma (see Fig. 1a,b). A karyotype of the angiolipoma was not performed. 1(a) Prominent vessels filled with fibrin thrombi at the periphery of mature fat lobules. (b) At higher magnification Because excision of one angiolipoma produced scarring with a poor cosmetic result, intralesional triamcinolone, 5 mg/mL, was tried without success.