Sclerosing granuloma after short-term administration of depot-insulin Hoechst. Case report and a review of the literature.

A 41-year-old male diabetic patient is described who exhibited firm infiltrative lesions on the abdomen and both buttocks after six injections of Depot-Insulin Hoechst. Initially there were no indications of an allergic or infectious origin. Histologic examination showed a sclerosing granuloma, suggesting a foreign body reaction. Oily substances could not be detected in a skin lesion or in the contents remaining in the insulin bottle. Skin tests suggested an allergic reaction to surfen. This side effect of insulin must be very rare. We could find only one report in the literature describing similar cases; no case was found in the files of Hoechst Limited. Data from literature concerning reactions to Depot-Insulin Hoechst and to surfen, one of its components, are reviewed.