Question of the Week
For October 6, 2020
A 47-year-old woman with poorly controlled type 2 diabetes, as well as hypertension and hyperlipidemia, reports a 1-month history of several new skin lesions. She denies fevers, chills, and joint pain. Her current medications are insulin, metformin, labetalol, simvastatin, and a multivitamin.
The skin lesions are reddish-yellow, pruritic, and painful. They are present on the backs of both legs and on the buttocks and knees (figures 1 and 2).
Laboratory testing reveals a glycated hemoglobin level of 11.9% (reference range, 4.3–5.6). The patient’s complete blood count, electrolytes, and kidney function are normal.
Which one of the following conditions is the most likely cause of this patient’s skin lesions?