Warts of the Fingertips in a Pediatric Patient With Type 1 Diabetes

An 11-year-old girl, diagnosed with type 1 diabetes 3 years ago, presented to the pediatric endocrinology clinic for her scheduled, quarterly follow-up visit. She and her mother received diabetes self-management instruction from a certified diabetes educator at the time of diagnosis and received ongoing self-management education at her regular visits. Her glucose control was suboptimal, with an A1C of 11.4% (normal <6.5%). The patient was largely responsible for her own diabetes care because her mother is a single parent and works full-time. During the visit, the patient’s mother mentioned that, in the past few months, the child had developed lesions on her fingertips. These lesions were appearing at the sites where she uses a lancet to prick her fingers for capillary blood glucose monitoring several times per day. The patient assured the diabetes care team that she used alcohol swabs to clean the …