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The main differential diagnosis is with other melanin-producing neoplasms, in particular melanoma

[9] [10] This dual action helps regulate blood glucose levels without causing hypoglycaemia when glucose concentrations are normal, though the risk of hypoglycaemia increases when used with insulin or sulfonylureas

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Chen YH, Zink T, Chen YW, Nin DZ, Talmo CT, Hollenbeck BL, et al

Risk of Amputation: There is an increased risk of lower limb amputation (toes, feet) associated with empagliflozin, particularly in patients with prior amputations, peripheral vascular disease, neuropathy, and diabetic foot ulcers

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