Iranian journal of diabetes and obesity, volume 4, number 2, summer 2012 91 skin manifestations of diabetes mellitus parichehr kafaie1, ahmad shojaoddinyardekani2 jomhouri blvd, yazd, iran. Bullosis diabeticorum bd, or diabetic bulla, is 1 of the cutaneous manifestations of diabetes mellitus, reported in 0. Cutaneous manifestations of diabetes mellitus ncbi. Cutaneous manifestations of diabetes mellitus pages with reference to book, from 304 to 305 zamaz wahid,anjum kanjee department of dermatology, dow medical college and civil hospital, karachi. Individuals with type 2 diabetes are more likely than those. Cutaneous manifestations of diabetes mellitus mahmood. Our purpose was to evaluate the prevalence and main clinical presentation of skin disorders in patients with dm. There remain several cutaneous abnormalities which are observed with increased frequency among diabetics, the significance of which is unknown. Individuals with type 2 diabetes are more likely than those with type 1 diabetes to develop cutaneous manifestations.
Dermatologic manifestations of diabetes incidence 3070% of diabetics in different studies may precede development of clinical diabetes prevalence similar in type 1 and 2 cutaneous infections are more common in type 2, whereas autoimmunerelated lesions in type 1 good metabolic control may prevent and help cure some 3. Skin of diabetic patient has increased capillary fragility, and blood vessels show decreased circulation. Study of cutaneous manifestations of type 2 diabetes. Noninfectious as well as infectious diseases have been described as dermatologic manifestations of diabetes mellitus. The cutaneous manifestations of diabetes mellitus are varied. Those families with a strong family history of diabetes should. In addition, we studied the relation of the cutaneous manifestations with diabetes duration, glycemic control, bmi, microvascular complications, and stratum corneum hydration using a stepwise logistic regression.
Diabetes is the most common endocrine disorder, affecting 8. Abnormal carbohydrate metabolism, other altered metabolic pathways, atherosclerosis, microangiopathy, neurone degeneration and impaired host mechanism all play a role. The commonest cutaneous feature of diabetes were pyodermas seen in 40% patients, dermatophytosis. Diabetes mellitus dm is a common disorder with a broad spectrum of cutaneous manifestations. Abnormalities of insulin and elevated blood glucose level lead to. As emphasized in the article recognition of these findings is a key for treatment and prevention. The international diabetes federation idf estimates the total number of diabetic subjects to be around 40. A study of cutaneous manifestations associated with. Diabetes mellitus is a leading cause of morbidity with adverse effects on various systems including skin find, read and. It never should be forgotten, though it often is, to what large degree. Diabetes mellitus dm is a heterogeneous group of disorders characterized by a high serum glucose level and by disturbances of carbohydrate and lipid.
Prevalence of cutaneous manifestations in patients with. Multiple factors play a role in the manifestations of cutaneous signs of dm. Diabetes mellitus is the most common endocrine disease characterized by various dermatological diseases and cutaneous manifestations in up to 70% of patients. Introduction diabetes mellitus is the most common endocrinal disorder and it is estimated that it will affect 300 million people worldwide by 2025 1. The binding of a glucose molecule to the tissue protein results in an effect on structure and function of that protein and results in clinical manifestations of the disease. The aim of the present study was to look for major skin findings in patients with diabetes mellitus and to see their clinical. The skin lesions may precede the symptoms and signs of diabetes mellitus. Though it is well known that diabetes is associated with a number of cutaneous manifestations, there is a relative paucity of studies looking at the prevalence of skin changes in young patients with type 1 diabetes.
Importantly, several cutaneous findings have systemic implications in patients with diabetes that should prompt the dermatologist to. As a result, the skin findings associated with these two diseases partially. Incidence of cutaneous patients had dermatoses strongly associated with dm including one each with waxy skin syndrome, granuloma annulare, eruptive xanthoma, scleredema adultorum and 2 cases of diabetic bullae. For a period of 6 months, all of the patients with dm attending the outpatient dermatology and diabetes clinics of the hamedan university of medical sciences, iran, were clinically. Diabetes mellitus is a morbid and costly condition that carries a high burden of disease for patients and society as a whole. Pdf cutaneous manifestations of diabetes mellitus researchgate. The symptomatology of diabetes is more readily recognizable in children than in adults, so it is surprising that the diagnosis may sometimes be missed or delayed, diabetes is a great imitator. Others may be manifestations of macro or microvascular disease. Cutaneous manifestations of diabetes mellitus and the. Pdf a study on the cutaneous manifestations of diabetes. Prevalence of cutaneous manifestations of diabetes mellitus.
We conducted a study of fifty patients having diabetes mellitus coming from the department of dermatology and medicine. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing. Importantly, diabetesrelated cutaneous lesions may also serve as a port of entry for secondary infection. Objectives to study the spectrum of dermatoses in patients with type 1 dm and the effects of disease duration and long. Dermatologic manifestations of diabetes mellitus endocrinology. Skin disorders, usually neglected and frequently underdiagnosed among diabetic patients, are common complications and encounter a broad spectrum of disorders in both type 1 and type 2 diabetes mellitus dme. A new appraisal of dermatologic manifestations of diabetes. In company with its direct analogue, histological as well as in some degree functional, the skin suffers many insults from the glycosuric state, subjectively, and often bears decided objective symptoms resulting therefrom. Diabetes mellitus dm is a clinical syndrome characterized by hyperglycaemia due to absolute or relative insulin deficiency.
The aim of this book is to focus on the cutaneous manifestations of diabetes. Spectrum of cutaneous manifestations of type 1 diabetes. The prevalence of a cutaneous disorder appears to be similar between type 1 dm and type 2 dm patients, but type 2 dm patients develop more frequent cutaneous. Continuing medical education the cutaneous manifestations of diabetes mellitus arthur c. Cutaneous manifestations of diabetesoriginal pdf all. Cutaneous manifestations of diabetes mellitus journal of the. Cutaneous manifestation of diabetes melitus mahajan s. Cutaneous manifestations were quite common in the diabetics of this area. Skin manifestations of diabetes mellitus endotext ncbi bookshelf. Cutaneous manifestations of diabetes mellitus cutaneous infections are more common in type 2 diabetes, whereas autoimmunerelated lesions are more common in type 1. The cutaneous manifestations were thus positively associated with diabetes and when tested, were statistically significant p0. Data on cutaneous manifestations of type 1 diabetes mellitus dm is scarce. Insulin injections, required for management of most diabetes in the pediatric age group, may also cause cutaneous changes.
Pruritus, necrobiosis lipoidica, scleredema adultorum of buschke, and granuloma annulare are examples. Cutaneous manifestations of dm can be broadly classified into four groups. Cutaneous manifestations are common in metabolic disorders, such as diabetes mellitus dm and the metabolic syndrome mets, and metabolic diseases may manifest with specific skin findings. Pattern of cutaneous manifestations of diabetes mellitus. Unfortunately, most glucoselowering drugs also have cutaneous side effects. Skin manifestations of diabetes abstract diabetes mellitus can be complicated by a variety of cutaneous manifestations. The cutaneous signs of diabetes are the manifestations of multiple factors. The cutaneous manifestations of dm are well known and considered as common, as observed in 3071% of diabetic patients 1, 2. Diabetes mellitus is a fairly common medical disorder that involves almost every specialty in its spectrum of clinical manifestation, and up to rd of patients with diabetes mellitus are estimated to have cutaneous changes. Global presence of type 2 diabetics in the year 2000 was 171 million which is likely to be 366 million in the year 2030. Cutaneous manifestations of diabetes mellitus clinical. Diabetes mellitus, cutaneous manifestations, iddm, niddm introduction diabetes mellitus dm is a clinical syndrome characterised by hyperglycaemia due to absolute or relative insulin deficiency.
Diabetes mellitus affects individuals of all ages and in all socioeconomic segments of the population. According to various studies, 30% to 91% of diabetic patients experience at least 1 dermatologic complication. Diabetes mellitus dm is a heterogeneous disease characterized by hyperglycemia. Diabetes mellitus skin symptoms due to diabetic vascular abnormalities diabetic microangiopathy both small and large blood vessels are affected in diabetes mellitus. Individuals with type 2 diabetes are more likely than those with. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts.
Cutaneous manifestations of diabetes occur because of the microvascular complications of diabetes, impaired wound healing, and other yet undetermined mechanisms. Cutaneous manifestations of diabetes mellitus type 2 who emro. Cutaneous manifestations of diabetes mellitus in 99 patients cutaneous manifestations no percentage. Diabetes mellitus dm is considered a modern epidemic disease that affects about 8. This book is a practical guide to diabetes mellitus and its manifestation on the skin. Bd, or diabetic bulla, is 1 of the cutaneous manifestations of diabetes mellitus, reported in 0. Cutaneous alterations in diabetes mellitus wounds research. In diabetic microangiopathy, there is proliferation of endothelial cells and deposits of paspositive material in the. Diabetes mellitus dm is a syndrome characterized by hyperglycemia and impaired metabolism of carbohydrates, proteins and fats due to an absolute or relative deficiency of the secretion andor. Diabetes mellitus dm is the most common endocrinal disease which frequently has skin manifestations. Cutaneous manifestations of diabetes, 1e true pdf january 1.
Patients with widespread granuloma annulare need to be screened for diabetes. The cutaneous manifestation of diabetes mellitus associated with diabetes mellitus and its treatment. Results diabetic skin manifestations were detected in 168 of 238 71% iddm patients and in 18 of 122 14% of the control subjects. Pdf cutaneous manifestations of diabetes mellitus and. Davis, ca in the last 10 years many new associations between diabetes mellitus and the skin have been noted. Metabolic diseases are commonly encountered in the western world. Classification of dermatologic lesions in diabetes mellitus there is considerable uncertainty about the pathogenesis of the many cutaneous conditions. Prevalence study of dermatologic manifestations among. Diabetic dermopathy dd, also known as pigmented pretibial patches or diabetic shin spots, is the most common dermatologic manifestations of. Good metabolic control may prevent some of these manifestations and may support cure. Moreover, diabetic neuropathy and angiopathy may also affect the skin. Cutaneous manifestations of diabetes mellitus in children. A study of 750 patients with diabetes found that the most common skin manifestations were cutaneous infections 47.
Introduction iabetes mellitus dm refers to a group of metabolic disorders with a common presentation of hyperglycemia. In other words using broadest criteria all subjects with diabetes will diabetes will develop cutaneous manifestations of this disease. Mets and dm share a common mechanism in their etiopathogenesis. Cutaneous manifestations generally appear subsequent to the development of diabetes but may be the first presenting sign or even precede the diagnosis by many.
Cutaneous manifestations of diabetes mellitus indian j. Poorly controlled type 2 diabetes mellitus dm is associated with several disorders and microvascular, macrovascular and neuropathic complications. Diabetes mellitus, insulin, cutaneous manifestations i. The aim of this study was to evaluate the frequency of skin manifestations in patients with diabetes mellitus of this area. Approximately 30% of patients with dm have skin lesions. Cutaneous manifestations of diabetes mellitus journal of. In dermatology, a great number of skin findings have been associated with diabetes, some demonstrating a stronger connection than others. Diabetes mellitus is a common disease, and the cutaneous manifestations of it are frequently encountered by the practicing dermatologist. Cutaneous manifestations due to treatment of diabetes mellitus lipodystrophy 1 1 2 3% skin rashes 2 2 4 6. Among the cutaneous disorders strongly associated with common in patients without cutaneous manifestations diabetes, 17 patients had diabetic dermopathy, 2 had 7. Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Cutaneous manifestations of diabetes mellitus request pdf.
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