Cutaneous manifestations of diabetes mellitus
Keywords:
Diabetes mellitus, cutaneous manifestationsAbstract
Background Diabetes is a common disease with a variety of skin manifestations encountered by dermatologists, Skin and diabetes may be linked by association (e.g. necrobiosis lipoidica); infections (bacterial, viral or fungal); diabetic complications (e.g. neuropathic ulcers or treatment reactions). The skin manifestations of diabetes affect up to two thirds of patients both type I and II diabetes mellitus. Cutaneous manifestations of diabetes occur because of the microvascular complications of diabetes, impaired wound healing, and other yet undetermined mechanisms.Objective The aim of the present study was to look for major skin findings in patients with diabetes mellitus and to see their clinical correlation.Patients and methods All patients attending the diabetic clinic during a period of one year from July, 2002 to June, 2003 were examined in detail for cutaneous manifestations of the disease.Results 162 patients, 92 females and 70 males, were enrolled. The overall prevalence of cutaneous manifestations was 81.5% (80% in type I and 83.4% in type II diabetics). These manifestations were microvascular (n=73), neurological (n=61), infections (n=46), iatrogenic (n=7) and miscellaneous (n=184).Conclusion Cutaneous manifestations are quite frequent in both types of diabetics. A number of new findings were observed.References
Perez MI, Kohn SR. Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol 1994; 30: 519-31.
Wahid Z, Kanjee A. Cutaneous manifestations of diabetes mellitus. J Pak Med Assoc 1998; 48: 304-5.
Paron NG, Lambert PW. Cutaneous manifestations of diabetes mellitus. Prim Care 2000; 27: 371-83.
Romano G, Moretti G, Di Benedetto et al. Skin lesions in diabetes mellitus: prevalence and clinical correlations. Diabetes Res Clin Pract 1998; 39: 101-6.
Stuart CA, Gilkison CR, Smith MM et al. Acanthosis nigricans as a risk factor for non-insulin-dependant diabetes mellitus. Clin Pediatr 1998; 37: 73-80.
Brownlee M, Vlassara H, Kooney A et al. Aminoguanidine prevents diabetes- induced arterial wall protein cross-linking. Science 1986; 232: 1629-32.
Delbridge L, Ellis CS, Robertson K, Lequesne LP. Non-enzymatic glycosylation of keratin from the stratum corneum of the diabetic foot. Br J Dermatol 1985; 112: 547-54.
Otsuji S, Kamada T. Biophysical changes in the erythrocyte membrane in diabetes mellitus. Rinsho Byori 1982; 30: 888-97.
Rahbar S. An abnormal hemoglobin in red cells of diabetics. Clin Chim Acta 1968; 22: 296-8.
Pongor S, Ulrich PC, Benesath FA, Cerami A. Aging of proteins: isolation and identification of a fluorescent chromophore from the reaction of polypeptides with glucose. Proc Nat Acad Sci USA 1984; 81: 2684-8.
Sell OR, Lapolla A, Odetti P et al. Pentosidine formation in skin correlates with severity of complications in individuals with long-standing. Diabetes 1992; 41: 1286-92.
Naheed T, Akbar N, Akbar N et al. Skin manifestations amongst diabetic patients admitted in a general medical ward for various other medical problems. Pak J Med Sci 2002; 18: 291-6.
Rehan TM, Gill MA, Aqil M et al. Is it a diabetic hand? J Surg Pak 2002; 7: 12-6.
Nern K. Dermatologic conditions associated with diabetes. Curr Diab Rep 2002; 2: 53-9.
Ferringer T, Miller F III. Cutaneous manifestations of diabetes mellitus. Dermatol Clin 2002; 20: 483-92.
lzakovic J. Skin manifestations of diabetes mellitus. Schweiz Rundsch Med Prax 2002; 91: 1011-8.
Ribes lA, Vanover-Sams CL, Baker OJ. Zygomycetes in human disease. Clin Microbiol Rev 2000; 13: 236-3.
Yosipovitch G, Hodak E, Vardi P et al. The prevalence of cutaneous manifestations in IDDM patients and their association with diabetes risk factors and microvascular complications. Diabetes Care 1998; 21: 506-9.
Kemmerly SA. Dermatologic manifestations of infections in diabetics. Infect Dis Clin North Am 1994; 8: 523-32.
Harris LF, Hon JK, Schreeder MT. Mucormycosis: a community hospital perspective. Ala Med 1990; 60: 38, 40-1.
Nozaki S, Sueki H, Fujisawa R et al. Glycosylated proteins of stratum corneum, nail and hair in diabetes mellitus: correlation with cutaneous manifestations. J Dermatol 1988; 15: 320-4.
Jamil M, Amin Z, Chaudhary TH et al. Management of diabetic foot infections. J ColI Physicians Surg Pak 2001; 11: 606-10.