title: Severe persistent biphasic local (immediate and late) skin reactions to insulin.
abstract: A patient with adult-onset insulin-requirging diabetes mellitus had persistent severe local reactions to all available insulins of animal origin. Skin reactions were biphasic in nature with both immediate and late characteristics. An extensive immunologic investigation of this problem was undertaken, revealing evidence of reaginic antibody involvement in the reactions. Routine histologic studies suggested the possibility that Arthus-type mechanisms played a part, although this impression was not confirmed by immunofluorescent microscopy. A program of medical management provided some relief of symptoms.
mesh_terms: D001232:Aspergillus fumigatus / Q000276:immunology; D001706:Biopsy; D003176:Complement C3 / Q000032:analysis; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology* / Q000276:immunology; D007136:Immunoglobulins / Q000032:analysis; D007328:Insulin / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D007330:Insulin Antibodies / Q000032:analysis; D008875:Middle Aged; D012867:Skin / Q000032:analysis / Q000276:immunology; D012882:Skin Tests
chemical_list: D003176:Complement C3; D007136:Immunoglobulins; D007328:Insulin; D007330:Insulin Antibodies; D005340:Fibrinogen