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Laser treatment for lipoatrophy in children with diabetes type 1

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Abstract

Introduction

Lipoatrophy (LA) is one of the complications of insulin treatment. It has become rare thanks to insulin analogues but it can still be observed in patients with diabetes type 1(T1DM). No effective treatment exists. Herein, we report for the first time two children with T1DM and LA successfully treated with laser treatment.

Clinical cases

A 6-year-old child with T1DM presented with LA 4 months post-diagnosis. He was on continuous subcutaneous insulin infusion (CSII). LA presented on body sites where insulin catheter was never inserted. He underwent different treatment options with no positive effect. Laser treatment was tried with impressive improvement. The second 9-year-old child presented with LA 5 years postdiagnosis. He changed the insulin type, the site of insulin injection, and tried topical use of sodium chromoglycate cream with partial improvement. Laser treatment was finally used with remarkable outcome.

Conclusion

Insulin-induced LA is now a rare skin complication with no effective treatment up to now. Laser treatment seems to be an effective treatment option.

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Abbreviations

TIDM:

Type 1 diabetes

LA:

Lipoatrophy

CSII:

Continuous subcutaneous insulin infusion

SCG:

Sodium cromoglycate

CO2 :

Carbon dioxide

References

  1. Kordonouri O, Biester T, Schnell K, Hartmann R, Tsioli C, Fath M, et al. Lipoatrophy in children with type 1 diabetes: an increasing incidence? J Diabetes Sci Technol. 2015;9(2):206–8.

    Article  Google Scholar 

  2. Kordonouri O, Biester T, Weidemann J, Ott H, Remus K, Grothaus J, et al. Lipoatrophy in children, adolescents and adults with insulin pump treatment: Is there a beneficial effect of insulin glulisine? Pediatr Diabetes. 2020;21(7):1285–91.

    Article  CAS  Google Scholar 

  3. Sawatkar GU, Kanwar AJ, Dogra S, Bhadada SK, Dayal D. Spectrum of cutaneous manifestations of type 1 diabetes mellitus in 500 South Asian patients. Br J Dermatol. 2014;171(6):1402–6.

    Article  CAS  Google Scholar 

  4. Binder E, Lange O, Edlinger M, Meraner D, Abt D, Moser C, et al. Frequency of dermatological side effects of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes. Exper Clin Endocrinol Diabetes. 2015;123(4):260–4.

    Article  CAS  Google Scholar 

  5. Holstein A, Stege H, Kovacs P. Lipoatrophy associated with the use of insulin analogues: a new case associated with the use of insulin glargine and review of the literature. Expert Opin Drug Saf. 2010;9(2):225–31.

    Article  CAS  Google Scholar 

  6. Shimizu I, Furuya K, Osawa H, Fujii Y, Makino H. A case of insulin-induced localized lobular panniculitis with evidence for the phagocytosis of insulin by histiocytes. Endocr J. 2007;54(3):477–80.

    Article  Google Scholar 

  7. Phua EJ, Lopez X, Ramus J, Goldfine AB. Cromolyn sodium for insulin-induced lipoatrophy: old drug, new use. Diabetes Care. 2013;36(12):e204–5.

    Article  Google Scholar 

  8. Banihashemi M, Nahidi Y, Maleki M, Esmaily H, Moghimi HR. Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis. Lasers Med Sci. 2016;31(4):733–9.

    Article  Google Scholar 

  9. Omi T, Numano K. The role of the CO2 laser and fractional CO2 laser in dermatology. Laser Ther. 2014;23(1):49–60.

    Article  Google Scholar 

  10. Lan T, Xiao Y, Tang L, Hamblin MR, Yin R. Treatment of atrophic acne scarring with fractional micro-plasma radio-frequency in Chinese patients: a prospective study. Lasers Surg Med. 2018;50(8):844–50.

    Article  Google Scholar 

  11. Campolmi P, Bonan P, Cannarozzo G, Bruscino N, Moretti S. Efficacy and safety evaluation of an innovative CO2 laser/radiofrequency device in dermatology. J Eur Acad Dermatol Venereol. 2013;27(12):1481–90.

    Article  CAS  Google Scholar 

  12. Brightman L, Goldman MP, Taub AF. Sublative rejuvenation: experience with a new fractional radiofrequency system for skin rejuvenation and repair. J Drugs Dermatol. 2009;8(11 Suppl):s9-13.

    PubMed  Google Scholar 

  13. Cannarozzo G, Sannino M, Tamburi F, Chiricozzi A, Saraceno R, Morini C, et al. Deep pulse fractional CO2 laser combined with a radiofrequency system: results of a case series. Photomed Laser Surg. 2014;32(7):409–12.

    Article  Google Scholar 

  14. Tenna S, Cogliandro A, Piombino L, Filoni A, Persichetti P. Combined use of fractional CO2 laser and radiofrequency waves to treat acne scars: a pilot study on 15 patients. J Cosmetic Laser Therapy. 2012;14(4):166–71.

    Article  Google Scholar 

  15. Sirithanabadeekul P, Tantrapornpong P, Rattakul B, Sutthipisal N, Thanasarnaksorn W. Comparison of fractional picosecond 1064-nm laser and fractional carbon dioxide laser for treating atrophic acne scars: a randomized split-face trial. Dermatol Surg. 2020;47:e58–65.

    Article  Google Scholar 

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Acknowledgements

The authors have no formal acknowledgements

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. A’ Department of Pediatrics, P&A Kyriakou Children’s Hospital, Diabetes Center, Thivon and Leivadias Str. Goudi, 11527, Athens, Greece

    Maria Xatzipsalti & Andriani Vazeou

  2. Dermatology Private Office, Athens, Greece

    Hlias Alvertis

Authors
  1. Maria Xatzipsalti
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  2. Hlias Alvertis
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  3. Andriani Vazeou
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Contributions

MX helped to collect the data, searched the literature wrote the manuscript. AH helped to the treatment, AV designed the study, reviewed, edited the manuscript and is the guarantor of this work and, as such, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Maria Xatzipsalti.

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Conflict of interest

None.

Ethics approval

All authors comply with the guidelines for human studies. Compliance with Ethics Guidelines. The local Ethical committee of ‘P&A Kyriakou Children’s Hospital, approved the study (7320/21.4.2021).

Informed consent

The patients and their parents have given their written informed consent to publish these cases.

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Cite this article

Xatzipsalti, M., Alvertis, H. & Vazeou, A. Laser treatment for lipoatrophy in children with diabetes type 1. Diabetol Int 13, 452–455 (2022). https://doi.org/10.1007/s13340-021-00547-w

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  • DOI: https://doi.org/10.1007/s13340-021-00547-w

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