Endocrinology

A 46-year-old woman with type 1 diabetes mellitus presented to the emergency department with wheals, flares, and severe pruritus of her face and trunk.

This patient has a 2-year history of red plaque with a yellow atrophic center on the leg, which has ulcerated over the past 3 months.

These velvety, hyperpigmented plaques are secondary to acanthosis nigricans, a common problem in patients with insulin-resistant states.

Hundreds of yellow papules developed on the trunk and extremities of this patient, whose diabetes was uncontrolled.