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This case of diabetes mellitus is reported because of the unusual location of the complicating gangrene and infection.
Mrs. S. L., aged 42, a married Jewish woman, seen in October 1931, gave a history of having had diabetes mellitus for six years, without any dietary or insulin treatment. After a short period of supervision of treatment, the patient went through a pelvic operation quite satisfactorily in November 1931, but refused to follow dietary instructions or take insulin. She was not seen again until Nov. 28, 1933, when she was found in a stuporous condition with "air hunger" and "acetone breath." Over the lower part of each labium majus was a large gangrenous area, from one of which (the right) was draining considerable pus. In addition there was a gangrenous area over each ischial region, with considerable sloughing of tissue on the right side. Between the labial and ischial areas involved
Elkin CWW. OCCURRENCE OF DIABETIC GANGRENE IN AN UNUSUAL LOCATION. JAMA. 1934;102(26):2182. doi:10.1001/jama.1934.62750260005009e