2304-P: Localized Acanthosis Nigricans Induced by Exogenous Insulin Delivery at Insulin Pump Site in Adolescent with Type 1 Diabetes

Introduction and Objective: Acanthosis nigricans (AN) is a hyperkeratotic dermatosis commonly associated with severe insulin resistance, typically in intertriginous areas. It has also been reported in adults with type 2 diabetes at sites of exogenous insulin injection when proper site rotation is not followed. Here, we present a novel case of a 14-year-old male with type 1 diabetes who developed localized AN at the site of continuous subcutaneous insulin infusion (CSII). Methods: The patient was diagnosed with type 1 diabetes at age 11, presenting with hyperglycemia (HbA1c 10.2%), polyuria, polydipsia, weight loss, and diabetic ketoacidosis. Initially managed with subcutaneous basal-bolus insulin for 16 months, he transitioned to insulin pump therapy. Results: Despite counseling on proper pump site rotation, he repeatedly placed the pump site on his abdomen for over 12 months and developed a hyperpigmented, velvety plaque superficial to the distal end of the infusion cannula (see figure). At the most recent clinic visit, his HbA1c was 6.1%, with a total daily insulin dose of 0.8 units/kg/day and a BMI at the 34th percentile. Conclusion: This is the first known report of localized AN at the CSII site in an adolescent with type 1 diabetes. It highlights a previously unreported complication of CSII and underscores the importance of appropriate insulin pump site rotation. Disclosure E. Los: None. E.M. Artz: None. T.A. Ford: None.