Case of a Diabetic Patient with Erythematous and Indurated Skin

Case presentation The 53-year-old man who was diagnosed with type 2 diabetes 20 years earlier presented to the clinic for the assessment of incipient nephropathy and retinopathy. His glucose control has been satisfactory since diagnosis (HbA1c under 7%). Recent diagnosis Incipient nephropathy: Microalbuminuria 200 mg/24 hours High systolic blood pressure: 140 mmHg High LDL cholesterol: 134 mg/dl A laser photocoagulation method was used to treat hard retinal exudates near the macula.

Current medications Metformin: 2.550 mg/day Detemir insulin: 50 U/day Aspart insulin Simvastatin 20 mg/day Candesartan: 16 mg/day AAS: 100 mg/day Physical examination Weight: 120 kg Height: 174 cm BMI: 30.27 kg/m2 Blood pressure: 150/75 mmHg Erythematous, indurated, and painless skin on the upper back and posterior neck of the patient was observed. The patient reported progressive hardening of the skin in…