Continuous Subcutaneous Insulin Infusion (CSII)-Associated Granulomatous Suppurative Reaction in Four Children With Type 1 Diabetes.

With the increasing use of continuous glucose monitors and continuous subcutaneous insulin infusion (CSII) devices in pediatric patients with type 1 diabetes (T1DM), dermatologic complications are being reported more frequently. We describe four children with T1DM who developed persistent erythematous nodules with suppurative granulomatous inflammation at prior CSII injection sites. Treatment responses varied: one child improved after transitioning to subcutaneous insulin injections, another with oral dapsone, a third after switching CSII devices and limiting placement to the abdomen, and a fourth with topical corticosteroids and antibiotic ointment. This rare complication appears unrelated to specific device models or insulin types, highlighting the need for further studies to identify risk factors and guide optimal management.