Cutaneous Manifestations Of Diabetes Mellitus Research Articles

Cutaneous Manifestations of Diabetes Mellitus in a Tertiary Care Hospital in Eastern India: A Cross-sectional Study

Background: Diabetes mellitus is a chronic metabolic disorder and is a major public health problem worldwide. Skin diseases can appear as the first sign of diabetes or can develop at any time in the course of the illness. Purpose: This study aimed to determine the pattern and prevalence of skin manifestations in patients with diabetes mellitus. Methods: An observational cross-sectional study was done on 80 Type 1 and Type 2 diagnosed diabetes mellitus patients and with informed consent, they were thoroughly examined for their respective skin disorders. Results: Among 80 patients, 35% of patients had infectious skin lesions, whereas 20% had noninfectious dermatosis only. More than one type of dermatosis was seen in 45% of patients. Candidal balanoposthitis was the most common fungal infection. Limitation: Limited sample in a single center. Conclusion: Infections were more prevalent compared to noninfectious disease in a population with uncontrolled diabetes mellitus. Pruritus was the most common disorder among the other diabetic complications.

Study of Cutaneous Manifestations and Nail fold Capillaroscopic findings in Diabetes Mellitus and their correlation with Diabetic Retinopathy and Nephropathy- A Cross Sectional Observational Study

Objective: Long-term diabetes can lead to complications including diabetic macro- and microangiopathy. Capillaroscopy is a non-invasive method to evaluate capillary microvasculature which can be used to demonstrate changes in capillary microarchitecture noted in diabetic microangiopathy. The objective of this study was to study cutaneous manifestations of diabetes mellitus (DM), nailfold capillaroscopic changes due to diabetic microangiopathy, as well as to determine association between nailfold capillaroscopy (NFC) and cutaneous manifestations due to DM. Materials and Methods: Two hundred cases suffering from type 2 DM having cutaneous manifestations were enrolled in the study. Patients with autoimmune diseases, smokers and on long-term corticosteroids were excluded from the study. Detailed history was taken and the cutaneous manifestations related to type 2 DM were noted. NFC was done for all ten fingers of all patients. Additional investigations including HbA1c, urine microalbumin and fasting lipid profile were performed. Results: Out of 200 cases, 88 showed positive findings on NFC with the most common finding being altered tortuosity (seen in 85.2% cases). Chi-square test was done to demonstrate association between duration of DM and NFC which showed P-value of 0.027, which is statistically significant. Of the cases having nailfold capillaroscopic findings, 69/88 (78.4%) were found to have elevated HbA1C levels, 57/88 (57.9%) were found to have changes of diabetic retinopathy and 56/88 (63.6%) were found to have changes of diabetic nephropathy. Conclusion: NFC can provide key data for determination of vascular damage in diabetic patients and, thus, allows evaluation of progression of the disease making this technique a potential future utility in microvascular disease evaluation.

Cutaneous manifestations of diabetes mellitus: Correlation with HbA1C level—A cross-sectional observational study from a tertiary care center in Eastern India

Cutaneous manifestations of diabetes mellitus: Correlation with HbA1C level—A cross-sectional observational study from a tertiary care center in Eastern India

Spectrum of Cutaneous Manifestations of Diabetes Mellitus: An Observational Study from a Tertiary Care Hospital

Background: Diabetes mellitus (DM) is the most common endocrine disorder. It exhibits a variety of multisystem complications involving the blood vessels, skin, eye, kidney, and the nervous system during the course of the disease process. The skin shares both the effects of acute gross metabolic derangement and chronic degenerative changes of diabetes, as it is an actively metabolizing tissue. Materials and Methods: This is prospective and observational study conducted in the Department of Dermatology, Narayana Medical College, Nellore. Patients diagnosed to have DM after the age of 30 years, includingknown cases of type 2 DM already on treatment or newly detected diabetic patients, based on the American Diabetic Association criteria. The cutaneous features in diabetics were compared with that of normal controls. An attempt was made to find out any association between cutaneous features of DM and internal organ involvement due to diabetes. Results: This study showed that in specific cutaneous disorders, Dermatophytosis was present in 12(17.1%) patients in controlled group and 23(32.9%) patients in uncontrolled group. Candidiasis was present in 11(15.7%) patients in controlled group and 22(31.4%) patients in uncontrolled group. Bacterial Infection was present in 13(18.5%) patients in controlled group and 26(37.1%) patients in uncontrolled group. Acanthosis Nigricans was present in 8(11.4%) patients in controlled group and 24(34.3%) patients in uncontrolled group. Acrochordon was present in 18(25.7%) patients in controlled group and 32(45.7%) patients in uncontrolled group. Onychomycosis was present in 7(10.0%) patients in controlled and 1 1 (15.7%) patients in uncontrolled group. Conclusion: This study shows the prevalence and variety of DM skin and nail manifestations in an effort to further acquaint dermatologists and other clinicians with diabetic dermatologic manifestations. This study provides an overview that may facilitate earlier detection and treatment of thedisorder. Also, this matter can help physicians and endocrinologists to have a visualized idea of DM control and situation.

An epidemiological study of cutaneous manifestations of diabetes mellitus at Tertiary Care Centre of North West Rajasthan (India)

Background: Diabetes mellitus is a metabolic disorder characterized by elevated fasting and postprandial blood glucose levels and disturbances in the carbohydrate and lipid metabolism. Diabetes is the most common endocrine disorder, affecting 8.3% of the population. Objectives: To study the prevalence of various dermatoses in the diabetic population. Materials and methods: This was an Hospital based cross sectional study. All the patients of Diabetes mellitus with cutaneous manifestations of both sexes and all ages, irrespective of their presenting symptoms, attending our dermatology outpatient department over one year period were included in this study. A detailed clinical history regarding onset and duration was taken and any associated symptoms were asked. After obtaining consent, a thorough systemic and dermatological examination was conducted and all details were entered in a structured proforma. Results: The common skin disorders observed were: fungal infections (29.5%), acrochordons (11.25%), bacterial infections (10.5%), diabetic pruritus (8.25%), icthyosis (5.5%), and acanthosis nigricans (5%). Higher prevalence was noted in type 2 diabetes mellitus then type 1diabetes mellitus. There was a significant correlation between cutaneous manifestations and duration of diabetes mellitus. Conclusion: Cutaneous involment in diabetes mellitus is quite prevalant which affect the quality of life of patients. It is found more frequently among type 2 diabetes mallitus and increasing duration of diabetes mellitus increases the possibility of cutaneus involment.Thus, in early-stage disorders such as callus and xerosis, detection and management appeared to be important in reducing complication related to diabetes mellitus.

Skin Barrier Changes in T1DM and T2DM

Cutaneous manifestations of diabetes mellitus (DM) are a group of skin disorders that characteristically arise from prolonged chronic hyperglycemia and impaired insulin signaling or insulin resistance. There are several skin diabetic pathologies associated with the two main types of diabetes-type 1 (T1DM) and type 2 diabetes (T2DM), which tend to negatively impact the patients quality of life.

Cutaneous Manifestation of Diabetes Mellitus in an Unsheltered Male Leading to Emergent Hospitalization

Diabetes mellitus (DM) is one of the most common chronic diseases in the United States. It is characterized by increased patient morbidity and mortality due to the many complications that can arise. Certain dermatological findings can be indicative of poorly controlled DM and can be a useful clue to further management. Persons experiencing homelessness (PEH) with DM often have higher rates of diabetic complications than the general diabetic population. Medical providers caring for PEH in the setting of limited resources should carefully evaluate cutaneous disease as a potential indicator of underlying illness. This physical manifestation of illness can serve to guide the next appropriate steps in management. A 41-year-old unsheltered male with an extensive medical history of hypertension, seizures, chronic diarrhea, and cocaine use was seen at a “foot-washing” medical outreach event. He presented with fevers, chills, and multiple painless right lower extremity ulcerated lesions of unspecified origin. A finger-stick glucose measurement was found to be 650 mg/dL. After immediate administration of 10 units of insulin, he was transported immediately to the emergency department and admitted. His month-long hospital course was complicated and involved the amputation of multiple toes. Preemptive outreach and management could have prevented the marked deterioration of his disease and represents the importance of outreach and regular follow-up with the PEH community.

English

BACKGROUND “Skin is a mirror of internal diseases”. Diabetes mellitus (DM) is a metabolic disorder that needs considerations of many different specialities but the importance of dermatologist’s knowledge has not drawn much attention. As a result, we intend to study various cutaneous manifestation of diabetes mellitus. Prior to diagnosis of diabetes mellitus, patient may present with cutaneous manifestation. Thus, it can help in early diagnosis, management and prevention of complication and help in improvement of quality of life. METHODS This is a descriptive cross-sectional study. A total of 500 diabetic patients with cutaneous manifestations, who attended skin outpatient department (OPD) at Kempegowda Institute of Medical Sciences Hospital and Research Centre, Bengaluru, Karnataka, India, were evaluated. Detailed history was taken along with physical and mucocutaneous examination. Cutaneous manifestations, general description of diabetes mellitus like duration, type, and drug history as well as the demographic data were collected and analysed using descriptive statistics. RESULTS Among a total of 500 diabetes mellitus subjects, the most common cutaneous manifestations were infections (35 %) followed by pruritus (11 %). Among infections, tinea infections (48.29 %) were the most common followed by intertrigo (21 %). CONCLUSIONS The ignorance of skin manifestations in diabetes or improper treatment may worsen the condition. Early detection and treatment of common skin manifestations in diabetes will prevent further complications especially in cases of extensive tinea corporis, pruritus, psoriasis, lichen planus, macro and micro angiopathies, trophic ulcers etc. KEYWORDS Cutaneous manifestations, Diabetes mellitus

Evaluation of Cutaneous Manifestation of Diabetes Mellitus

Introduction: Diabetes Mellitus (DM) is known to be a chronic multisystem disorder. Since the cutaneous manifestation can be the presenting sign of diabetes mellitus. These are well known and considered common. This work is an attempt to analyze the pattern of various cutaneous manifestations seen in DM in the present lifestyle scenario. In view of increasing prevalence of diabetes mellitus a study of cutaneous manifestation cannot be over emphasized. Aim: To analyze and study the pattern of cutaneous manifestations in diabetic patients. Material and methods: An observational single centered study of 18 months was conducted in department of Dermatology and Medicine at tertiary care teaching hospital. Results: A total of 100 (males were constituted 55% and females were constituted 45%) diagnosed patients of Diabetes Mellitus and were examined. Cutaneous infections were the most common(71%) such as skin tags (33%), cherry angioma (21%), xerosis of skin (19%), acanthosis nigricans (18%), generalized pruritus (12%), xanthelasma palpebraum (8%), diabetic dermopathy (7%), yellow discolouration of hand (5%), diabetic thick skin (2%), rubeosis faciei (2%), and granuloma annulare (1%). Conclusion: It is important to educate patient for proper self-examination, diet control, exercise, change in lifestyle, regular treatment along with monitoring of blood sugar (HbA1c) at regular intervals to detect infections and other manifestations of DM.

A clinical study of cutaneous manifestations in diabetes mellitus

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.

Dermatological manifestations in diabetes mellitus

Diabetes mellitus (DM) is the common endocrine disorder, which affects all ages and socioeconomic groups. The prolonged hyperglycemia may responsible for the diabetic complications. Multiple factors contribute to the onset of cutaneous manifestations in diabetes mellitus. The present study aimed tostudy the pattern of various cutaneous manifestations associated with diabetes mellitus.The present study was conducted at Dermatology, Diabetic Clinic of a teaching tertiary care centre hospital. A total of 120 subjects were included in this study. Patients were selected on the basis of dermatological signs and/or symptoms. Detailed history and clinical examination with special emphasis on dermatological complaints and signs was done for all the study subjects. Under aseptic conditions, blood samples were collected and used for the estimation of blood glucose, bacterial infections-Gram stain and isolation of organism by culture, fungal infections- KOH (potassium hydroxide) mount, Gram stain (for Candida) and isolation of organism by culture. Skin biopsies were performed wherever necessary.In the present study, 120 subjects were included from both genders. Pruritus was the predominant symptom observed. Acrochordons, Candidial Balanoposthitis, Tinea Corporis were observed in highest number of patients. Infective dermatoses were observed in 72 (60%) patients. The non-infective dermatoses was reported in 56 (46.7%) patients. On bacterial culture, Pyogenic Ulcer was observed in 4. KOH test and culture were carried on 14 candidal infections and 17 dermatophyte infection and observed KOH mount positive were observed in 11 cases and culture positive was observed in 8 cases.In the present study results indicates pruritus was the most common symptom in diabetic subjects. Infective dermatoses were more common than the non-infective dermatoses. Tinea corporis/cruris was most common clinical entity. 21.6% patients suffered from cutaneous bacterial infections, the most frequently encountered clinical entity being furunculosis. Staphylococcus aureus The commonest non-infective clinical entity was acrochordons(skin tags). Patients with diabetes may develop cutaneous manifestations of diabetic complications. Careful dermatological examination and follow-up of diabetes mellitus patients is required to provide them adequate skin management.

A Study on the Prevalence of Cutaneous Manifestations of Diabetes Mellitus

A Study on the Prevalence of Cutaneous Manifestations of Diabetes Mellitus

Pattern of Cutaneous Dermatoses in Type 2 Diabetes Mellitus in a Tertiary Hospital: A Cross Sectional Study

Background: Diabetes mellitus (DM) continues to be a major public health problem. Multiple factors have a role in the skin manifestations of DM. Cutaneous manifestations of DM are very important to the clinician.
 Methods: Current study was carried out in the Department of Dermatology and Venereology, Shaheed Suhrawrdy Medical College Hospital, Dhaka, spanning from 1st January 2017 till 30th June 2017 over a period of six months. Adult patients already diagnosed to be suffering from type 2 DM presenting with cutaneous manifestations were included in the study.
 Results: Majority (68.0%) patients had diabetes >5 years, 16.7% had < 1 year and 15.3% had 1-5 years. Family history of DM was found in 70.7% in this study. In this study bacterial infection and fungal infection were more common in female patients (60.0% vs 62.0% respectively). Regarding types of dermatoses, fungal infection was more common in this study 50(33.3%). Others were bacterial infection 20(13.3%), viral infection 7(4.7%) and parasitic infection 7(4.7%). Papulo squamous disease was found 31(20.7%) patients, other diseases were 32(21.3%).Viral infection was more in male patients (71.4%). Parasitic infection was high in female patients 6(85.7%). Papulo squamous diseases was found 21(67.7%) in female patients.
 Conclusion: In this study fungal infection, bacterial infection, viral infection and parasitic infections were found to be the more common cutaneous dermatoses among adult diabetic patients. Bacterial infection and fungal infection were more common in female patients.
 TAJ 2018; 31(1): 21-28

Cutaneous manifestations in diabetes mellitus: A study among 500 patients in a tertiary care center in South India

Cutaneous manifestations in diabetes mellitus: A study among 500 patients in a tertiary care center in South India - IJCED- Print ISSN No: - 2581-4710 Online ISSN No:- 2581-4729 Article DOI No:- 10.18231/j.ijced.2019.031, IP Indian Journal of Clinical and Experimental Dermatology-IP Indian J Clin Exp Dermatol

Skin and diabetes: an experts' opinion from the Italian diabetologists and dermatologists of the DiaDex group.

The metabolic changes associated with diabetes mellitus (DM) affect a variety of organs and systems, including the skin. Skin lesions are frequently observed in patients with DM, resulting from a complex interaction among biochemical, vascular, immune, and metabolic changes. Cutaneous manifestations may develop at any time in the course of DM. They can be the first sign of the disease, possibly helping in diagnosis, or represent a marker of poor glycemic control. Given the high prevalence of cutaneous manifestations in DM, their possible role in favoring DM early diagnosis, and their relationship with the patient's metabolic control, a group of Italian dermatologists and diabetologists, the DiaDex expert group, jointly formulated a few basic statements aimed at favoring a stricter interdisciplinary cooperation in order to improve patients' management. Deeper knowledge of the skin lesions most commonly associated with DM, their early identification, and prompt reciprocal referral, when appropriate, are the pivotal points of these statements and should represent the pillars of such desired cooperation. The dermatologists and diabetologists of the DiaDex group believe that their different diagnostic and therapeutic skills put together may significantly benefit the many DM patients with cutaneous complications and hope that this paper may provide some guidance on how to achieve this goal.

Spectrum of Cutaneous Manifestations of Diabetes Mellitus: An Observational Study from a Tertiary Care Hospital

Introduction: Diabetes leads to destruction all over the body and the skin is not exempted from the attack. The skin shares both the effects of acute gross metabolic derangement and chronic degenerative changes of diabetes, as it are an actively metabolizing tissue.Aims and objectives: To study the clinical patterns of dermatological manifestations of diabetes mellitus in the region of eastern India.Methods: Sixty consecutive subjects with diabetes mellitus having dermatological manifestations and satisfying the inclusion criteria were included in this study.Results: Bacterial infections were the commonest dermatological disorder (46.7%). Different forms of dermatophyte infections and candidiasis were found in 30% and 23.3% subjects, respectively. Diabetic dermopathy or ‘shin spot’ and diabetic foot with gangrenous changes were found in 20% and 13.3% subjects, respectively. Skin manifestations associated with diabetes were the second most common skin disorders and constituted 43.3% (26 out of 60 cases). Pruritus of unknown origin and xerosis (13.3%) were the most common cutaneous abnormalities in the group associated with diabetes. Other cutaneous manifestations, namely pigmented purpuric dermatosis (6.6%), psoriasis (3.3%), vitiligo (6.6%), lichen planus (3.3%), porokeartosis (3.3%), sclerosis, diabetic thick skin and contracture (6.6%), lipodystrophy (3.3%), skin rashes (6.6%) and scar with abscess (1.6%), were very rare.Conclusions: Our study has provided some insights into the pattern of dermatological manifestations in diabetes mellitus. A larger prospective study will further consolidate our main objective that management of diabetes is a holistic one and due attention on skin complications is warranted.

A Clinical Study about Cutaneous Manifestations of Diabetes Mellitus in a Tertiary Care Hospital

A Clinical Study about Cutaneous Manifestations of Diabetes Mellitus in a Tertiary Care Hospital

Cutaneous manifestations of diabetes mellitus and the metabolic syndrome

Metabolic diseases are commonly encountered in the Western world. 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. MetS and DM share a common mechanism in their etiopathogenesis. As a result, the skin findings associated with these two diseases partially overlap. Several skin findings in DM and MetS may be the first clinical features of the disease, and early diagnosis facilitates treatment, thereby helping in preventing long-term complications. In this review, MetS and skin manifestations associated with DM are discussed.

Cutaneous manifestations of diabetes mellitus in Iraqi patients

Objective:- To evaluate the incidence and types of cutaneous manifestations in diabetic patients in Iraq. Patients and methods:- One hundred diabetic patients attended the department of dermatology and venereology was evaluated. Sixty of them were male and 40 female. Sixty two percent of them had type I and 38% had type I diabetes mellitus I.Result: - Neuropathic cutaneous lesions were found in 32.43% of patients. Dryness of the skin and hair loss being the commonest. Vascular skin lesions were 14.86 %, diabetic dermopathy and necropiosis lipodica constitutes the highest percent. Cutaneous infections occurred in 20.7% weather bacterial or monilial infection. Drug eruptions were 10.36%, commonly complicate insulin therapy. Other miscellaneous skin lesions appeared in 21.62%. Purities were the commonest.
 Conclusion: - Diabetic skin manifestations are not uncommon in both types of diabetes mellitus.

Cutaneous manifestations of diabetes mellitus in children

Skin lesions in diabetes mellitus may be caused by metabolic disorders and develop due to insulin injections as a result of concurrent infection or in syndromic forms of diabetes. The skin lesions caused by metabolic disorders include diabetic dermopathy, diabetic bladder, necrobiosis lipoidica, granuloma annulare, eruptive xanthomas, scleroderma, and vitiligo. Children and adolescents with diabetes mellitus have frequently skin infections, such as cutaneous and mucosal candidiasis (stomatitis, vaginitis, onychomycosis, paronychia, perleche, and candidiasis ofskin folds and interdigitalspaces), and bacterialskin infections. The sequels of insulin injections include post-injection lipodystrophies, swelling, and allergic reactions. Early referral to a dermatologist assistsin identifying skin changesin the early stage of diabetes and in using timely combination therapy.