A Pigmented Bullous Maxillofacial Lesion in a Diabetic Patient: A Diagnostic Dilemma.

ABSTRACT

Diabetes mellitus (DM) can be complicated by a variety of cutaneous manifestations. Cutaneous manifestations, such as neuropathic foot ulcers are universally known and have predilection for the lower extremity. However, in the maxillofacial region diabetic lesion is not yet reported in the literature. It is because of enormous blood supply to the region. We present a case of 77-year-old female with pigmented bullous lesion in maxillofacial region as a result of uncontrolled DM, which was associated with reactive lymphadenitis due to infection from carious right mandibular first molar. The patient also had normocytic normochromic anemia secondary to progressive renal failure as a result of diabetic nephropathy (DN). The patient developed lesion due to trauma following fine-needle aspiration cytology and high sugar levels. She was successfully managed by good metabolic control, extraction of the offending tooth, antibiotic prophylaxis, and occlusive dressings. To the best of our knowledge, this clinical scenario has not been previously reported in the context of the diabetic lesion and, therefore, may be considered in the classification of dermatological lesions of diabetes.