A clinical study of cutaneous manifestations in diabetes mellitus

Abstract

Background: Diabetes mellitus (DM) is the most common endocrine disorder1.At least 30% of diabetics have some cutaneous involvement during the course of their disease 1. Type II patients do develop more frequent cutaneous infections, whereas type I patients develop more autoimmune- type cutaneous lesions 2,3. Objective: To evaluate the prevalence and pattern of skin manifestations among diabetic patients. Methods: 100 patients of diabetes mellitus with skin manifestations who consecutively attended DVL outpatient department and willing to participate in the study were enrolled in this study. Skin examination was done and findings entered to computer database for analysis. Results: Among 100 patients, there were 56 males and 44 females the youngest patient being 19 years old and eldest was 77 years old. Cutaneous infections were the most commonly observed dermatoses (51%), followed by dermatoses more commonly associated with diabetes mellitus (36%), non specific dermatoses (23%), neuropathic and ischemic diabetic skin disease (5%), due to microangiopathy (4%), metabolic disorders (3%) and cutaneous reactions to therapy (3%).Among cutaneous infections, fungal infections (38%) are the most common dermatoses followed by bacterial infections (11%) and viral infections (2%). Tinea corporis was the most common fungal infection and furunculosis (3%) was most common bacterial infection. Among the common dermatoses associated with diabetes mellitus (36%) majority presented with pruritus secondary to xerosis (12 patients, 12%) followed by 11 cases (11%) of psoriasis, 4 cases of vitiligo, 2 patients each (2%) of acrochordons, lichen planus and macular amyloidosis, 1 patient each (1%) of acanthosis nigricans, alopecia universalis and kyrles disease. Among patients with non specific dermatoses, eczema was most common followed by pemphigus, acne vulgaris and hidradenitis suppurativa. Conclusion: Infections were the most common cutaneous manifestations in diabetes, followed by dermatoses most commonly associated with diabetes. Cutaneous manifestations are more common in patients who have overall poor glycemic control. Cutaneous manifestations can heighten the suspicion of a physician regarding the diagnosis of diabetes and help to prevent systemic derangements by early institution of appropriate treatment.