Trans-Epidermal Elimination Due to Insulin Formulation: Report of a Rare Adverse Effect

July 2025 in “ Indian Dermatology Online Journal ”

Abhipsa Samal, Aurobinda Bhoi, Jayashree Mohanty, Swapnarani Behera, Adyasa Basa, Siddhartha Dash

trans-epidermal elimination isophane insulin foreign body granulomatous reaction perforating dermatoses insulin excipients

TLDR Switching insulin brands caused skin lesions in a diabetic woman, resolved by changing to oral medication.

A 45-year-old female with type-2 diabetes experienced trans-epidermal elimination (TEE) of insulin formulation, presenting as itchy lesions at injection sites. The condition was linked to a change in her isophane insulin brand, leading to a foreign body granulomatous reaction. Histopathology confirmed TEE, and treatment involved switching to oral diabetes medications, resolving the lesions. This case highlights the need to consider rare causes of perforating dermatoses beyond common ones, as insulin and its excipients can induce such reactions.

View this study on journals.lww.com →

Discuss this study in the Community →

Related Community Posts Join

6 / 394 results

Compressed part of research of theory of androgenic/anabolitic balance. AGA h-responders analytic. Theory of physio-metabolitic method of anti AGA treatment

community Compressed part of research of theory of androgenic/anabolitic balance. AGA h-responders analytic. Theory of physio-metabolitic method of anti AGA treatment

in Research 865 upvotes 1 year ago

The treatment for androgenetic alopecia involves using finasteride and minoxidil with intense exercise and cold exposure to boost metabolism and reduce androgenic effects, potentially leading to hair regrowth. This approach may activate biological pathways for improved hair and overall health.

community 6 months progress no fin 27m topical foam minox

in Progress Pictures 250 upvotes 2 years ago

The user has been using 5% Minoxidil foam twice daily, microneedling every two weeks, and Nizoral 2% shampoo weekly for hair loss treatment. They've seen improvements in their hairline and eyelashes, and are considering adding finasteride to their regimen.

community PP405: The Ultimate Hair Loss Drug for Complete Hair Growth

in Research/Science 212 upvotes 1 year ago

PP405 is a new hair loss treatment in phase 2 trials that may promote hair growth by increasing lactate production and activating hair follicle stem cells. It could potentially replace hormone-disrupting treatments like Minoxidil and finasteride.

community Minoxidil Response Bottlenecks: Why Sulfation and Transport Matter (And Where Tretinoin Fits In)

in Research 461 upvotes 8 months ago

Minoxidil's effectiveness is limited by the need for sulfation and proper transport to hair follicles, with tretinoin potentially enhancing its effects by promoting enzyme activity and keratinocyte differentiation. Tretinoin may improve minoxidil's response by boosting the expression of necessary enzymes and transporters.

community Has anybody tried retinol (not Retin A aka tretinoin) combined with minoxidil?

in Treatment 20 upvotes 3 years ago

The conversation is about someone who had success using retinol with minoxidil for hair growth, but experienced shedding with Retin A (tretinoin). They are asking if others have tried retinol with minoxidil and what their results were.

community 5 alpha reductase type 1 is in brain tissue producing the main endogenous gabaergic allopregnanolone, not 2. How can finasteride as a 5ar2 lower that?

in Finasteride/Dutasteride 28 upvotes 1 year ago

Finasteride and dutasteride are discussed for hair loss, with concerns about their effects on neurosteroids and potential side effects like depression. Alternatives like topical estrogen and lifestyle changes are considered, with varying opinions on mental health and hair regrowth.

Similar Research

5 / 1000+ results

research Complementary and Alternative Medicine for Vitiligo

5 citations , December 2011 in “InTech eBooks”

Eat antioxidant-rich foods, reduce fast food, and explore various treatments for vitiligo.

Posters Presented at the 19th Joint Meeting of the International Society of Dermatopathology, March 2–3, 2016, Hilton Crystal City at Washington Reagan National Airport, Arlington, Virginia, USA

research Posters Presented at the 19th Joint Meeting of the International Society of Dermatopathology, March 2–3, 2016, Hilton Crystal City at Washington Reagan National Airport, Arlington, Virginia, USA

July 2016 in “American Journal of Dermatopathology”

The meeting showcased rare skin disease cases, highlighting the need for accurate diagnosis and treatment.

Targeting Lymphoid-Derived IL-17 Signaling to Delay Skin Aging