Naslov
Case records of the Vuk Vrhovac University Clinic

Autori
Ljubić, Spomenka ; Car, Nikica ; Pavlić-Renar, Ivana ; Metelko, Željko

Izvornik
Diabetologia Croatica (0351-0042) 28 (1999), 2; 77-79

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
Granuloma annulare ; necrobiosis lipoidica ; diabetes mellitus

Sažetak
A 48-year-old man was admitted to the hospital for glycemic control and evaluation of late complications of diabetes mellitus. Care was focused on skin lesions of both pretibial areas. Clinical diagnosis was necrobiosis lipoidica. Until then, the patient had suffered no diseases except for an operation of the right leg ten years before because of variceal bleeding. Diabetes mellitus had been diagnosed two years before, and the patient was receiving an oral hypoglycemic agent, gliquidone. On admission, he was on one tablet of gliquidone in the morning. He was not on diet, and reported a weight loss of 12 kg over the past two years. The patient's blood pressure was 130/90 mm Hg, body temperature 36.4 °C, pulse 86, and he reported no problems with his appetite, stool or urination. There was no history of smoking or alcohol ingestion. The results of physical examination were normal, with the exception of some areas of atrophic hyperpigmented skin on both pretibial regions and swelling of the right lower leg. Laboratory test results showed considerable elevation of glycemia and glycated hemoglobin (HbA1c, 16.46%), and slight elevation of the blood leukocyte count, total cholesterol and LDL-cholesterol. Radiography showed hilar enlargement. Funduscopy pointed to nonproliferative retinopathy and maculopathy bilaterally. Neurologic examination indicated mild polyneuropathy. As mentioned above, attention was focused on skin lesions, thus skin biopsy was performed. The pathohistologic finding pointed to the diagnosis of granuloma annulare. The biopsy material was also submitted to direct immunofluorescent test (DIF). IgA± deposits, C3++, C1q(+) and fibrinogen were found in the blood vessels of the corium.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA