Endocrine System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"At a first glance, this patient seems to have presented with a common problem: eczema of the groin. While this seems to have been unusually resistant to treatment, it could very well be due to poor patient compliance.\n\nThe remainder of his history also seems benign. As he suspects, the weight loss could be due to a change in diet; and the worsening diabetes might be due to a sedentary lifestyle, poor compliance with medications, or merely the natural course of the disease.\n\nMore puzzling are the findings of angular cheilitis, glossitis, and conjunctival pallor. With respect to the latter, a complete blood count reveals anemia, with blood smears showing this to be a normochromic normocytic anemia. Advanced diabetic kidney disease comes to mind, but is made clinically less likely by the normal renal functions.\n\nThe unusual lesions in his groin provide a clue: these are highly suggestive of necrolytic migratory erythema (NME). Glucagonoma syndrome is the most common cause of this rash; ot"}]}

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