Spectrum of cutaneous manifestations in diabetes mellitus and their association with duration of diabetes mellitus: An observational study in a tertiary care hospital of South India.
DOI:
https://doi.org/10.66344/jpad.v27i3.138Keywords:
Cutaneous manifestations, diabetes mellitus, infections, South IndiaAbstract
Objective To study the prevalence and patterns of cutaneous manifestations among diabetic patients and their association with duration of diabetes mellitus (DM).
Methods A cross-sectional study was performed on patients attending the outpatient department of Dermatology, Venereology and Leprosy of a tertiary care hospital in South India. A total of 200 patients with dermatological manifestations having pre-existing diabetes and patients in whom diabetes was diagnosed later were included in the study. Statistical analysis was carried out using analysis of variance (ANOVA) test and SPSS 21 software.
Results Majority of patients (63%) belonged to the age group 40-59 years with female preponderance (58.5%). Cutaneous manifestations as presenting feature of diabetes were observed in 21.5% cases. The diabetic status was uncontrolled in 73% cases. Among the various cutaneous manifestations observed, cutaneous infections (52%) were most commonly observed, especially in early diabetics of upto 5 years duration and dermatoses due to chronic degenerative complications were observed in long-standing diabetics which was statistically significant (P<0.05).
Conclusion Cutaneous manifestations may be the first clue to underlying DM. Through awareness about cutaneous manifestations of DM, dermatologist can not only take credit for detecting DM but also facilitate early diagnosis of systemic complications of DM and thereby play an important role in improvement of quality of life and management strategy of diabetic patients.
References
1. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387:1513-30.
2. Bhat YJ, Gupta V, Kudyar RP. Cutaneous manifestations of diabetes mellitus. Int J Diab Dev Ctries. 2006;26:152-5.
3. Kalus AA, Chein AJ, Olerud JE. Diabetes mellitus and other endocrinal disorders. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Lefell DJ, editors. Fitzpatrick’s Dermatology in General Medicine. 7th edn. New York: McGraw-Hill: 2008. p. 1461-84.
4. Al-Mutairi N. Skin diseases seen in diabetes mellitus. Bull Kuwait Inst Med Special. 2006;5:30-9.
5. Bud JL, Oledur JE. Diabetes Mellitus. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Lefell DJ, editors. Fitzpatrick’s Dermatology in General Medicine. 7th edn. Vol. 2. New York: McGraw-Hill. p. 1651-61.
6. Jelinek JE. Cutaneous manifestations of diabetes mellitus. Int J Dermatol. 1994;33:605-17.
7. Peterka ES, Fusaro RM. Cutaneous Carbohydrate Studies IV. The skin glucose content of fasting diabetics with and without infection. J Invest Dermatol. 1966;46:459-63.
8. Mahajan S, Koranne RV, Sharma SK. Cutaneous manifestation of diabetes mellitus. Indian J Dermatol Venereol Leprol. 2003;69:105-8.
9. Nigam P K, Pande S. Pattern of dermatoses in diabetics. Indian J Dermatol Venereol Leprol. 2003;69:83-5.
10. Sawhney M, Talwar OP, Tutakne MA, Rajpathak SD. Diabetic dermoangiopathy: A clinico-pathological correlation. Indian J Dermatol Venereol Leprol. 1992;58:173-8.
11. Rao S, Pai G. Cutaneous manifestations of diabetes mellitus. Indian J Dermatol Venereol Leprol. 1997;63:232-34.
12. Al-Mutairi N, Zaki A, Sharma AK, Al-Sheltani M. Cutaneous manifestations of diabetes mellitus. Med Princ Pract. 2006;15:427-30.
13. Vahora R, Thakkar S, Marfatia Y. Skin, a mirror reflecting diabetes mellitus: A longitudinal study in a tertiary care hospital in Gujarat. Indian J Endocr Metab. 2013;17:659-64.
14. Yosipovitch G, Hodak E, Vardi P, Shraga I, Karp M, Sprecher E 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.
15. Feringer T, Miller FO. Cutaneous manifestation of diabetes mellitus. Dermatol Clin. 2002;20:483-92.
16. Hahler B. An overview of dermatological conditions commonly associated with the obese patient. Ostomy Wound Manage. 2006;52:34-6.
17. Sibbald RG, Schachter RK. The skin and diabetes mellitus. Int J Dermatol. 1984;23:567-84.
18. Binkley GW. Dermopathy in the diabetic syndrome. Arch Dermatol. 1965;92:625-34.
19. Crook MA. Skin tags and atherogenic lipid profile. J Clin Pathol. 2000;53:873-4.
20. Kahana M, Grossman E, Feinstein A, Ronnen M, Cohen M, Millet MS. Skin tags: A cutaneous marker for diabetes mellitus. Acta Dermatol Venereol. 1987;67:175-7.
21. Thappa DM. Skin tags as markers of diabetes mellitus: An epidemiological study in India. J Dermatol. 1995;22:729-31.
22. Kahn CR, Flier JS, Bar RS, Archer JA, Gorden P, Martin MM et al. The syndromes of insulin resistance and acanthosis nigricans: Insulin-receptor disorders in man. N Engl J Med. 1976;294:739-45.
23. Ragunatha S, Anitha B, Inamadar AC, Palit A, Devarmani SS. Cutaneous disorders in 500 diabetic patients attending diabetic clinic. Indian J Dermatol. 2011;56:160-4.
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Copyright (c) 2018 Swapna Kameti, Senthil Kumar A L, Vijaya Mohan Rao A, Penchala Reddy P, C Aruna
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