Insulin Associated Amyloidoma

Summary: Insulin derived amyloidosis is a rare condition that manifests from long-term subcutaneous insulin administration to the same area repeatedly. The amyloid can prevent insulin absorption leading to poor glycemic control. We present a case of an insulin dependent patient with type two diabetes with an abdominal nodule. A 74-year-old with past medical history of type two diabetes and obesity presented to his dermatologist with a right lower abdominal nodule. Punch biopsy demonstrated dermal deposits consistent with amyloidosis, demonstrating apple-green birefringence on Congo Red staining and thioflavin revealing diffuse fluorescence in the dermal deposits. This case illustrates the importance of clinical history and having a broad differential for subcutaneous nodules and dermal deposition disorders.