Cellulite and the Occult Diabetic

Harris, Richard; Hardman, David; Brown, Alastair R.

doi:10.1111/j.1445-2197.1996.tb01151.x

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…In other studies [14], [17] this association has not been established. However, Harris et al suggested an association with glucose intolerance [31]. Diabetes affects the healing process [32].…”

Section: Discussionmentioning

confidence: 99%

Comorbidities as Risk Factors for Acute and Recurrent Erysipelas

Brishkoska-Boshkovski¹,

Kondova-Topuzovska²,

Damevska³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Erysipelas is a common infectious skin disease. A typical feature of erysipelas, especially on the lower limbs, is the tendency to reoccur and the study aimed to define the comorbidities associated with it. AIM: We aimed to investigate systemic and local comorbidities in patients diagnosed with erysipelas on the lower limbs. MATERIAL AND METHODS: We conducted a retrospectively-prospective, population-based cohort study which included all patients diagnosed with erysipelas on the lower limbs, during two years. Patients were divided into two groups: patients with first episode and patients with recurrent erysipelas. These two groups were compared, with particular emphasis on systemic and local comorbidities. RESULTS: The study included 313 patients, of which 187 with the first episode of erysipelas and 126 with a recurrent. Regarding the analyzed systemic risk factors, the recurrent erysipelas was significantly associated with obesity (p < 0.0001), insulin dependent diabetes mellitus (p = 0.0015), history of malignant disease (p = 0.02) and tonsillectomy (p = 0.000001). For a p-value < 0.0001, significantly more frequent finding of peripheral arterial occlusive disease, chronic oedema/lymphoedema, fungal infections of the affected leg and chronic ulcer was confirmed in recurrent erysipelas. Neuropathy had 23% of the recurrent cases and 8.6% in patients without recurrence, and the difference was found to be significant for p = 0.0003. The only dissection of the lymph nodes was found more frequently in recurrent erysipelas (p = 0.017), but no associations with other analysed local surgery on the affected leg. Patients with recurrent erysipelas had ipsilateral coexisting dermatitis p = 0.00003 significantly more frequent. Minor trauma often preceded the first episode of erysipelas p = 0.005. CONCLUSION: Identification and treatment of modifiable risk factors are expected to reduce the risk of a subsequent episode of erysipelas on the lower limbs

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Section: Discussionmentioning

confidence: 99%

Comorbidities as Risk Factors for Acute and Recurrent Erysipelas

Brishkoska-Boshkovski¹,

Kondova-Topuzovska²,

Damevska³

et al. 2019

Open Access Maced J Med Sci

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“…There is an association between colonisation with S. aureus and local and systemic infections, which are responsible for significant morbidity and mortality in diabetes [62,64]. In the case of common skin infections, S. aureus is the most common pathogen isolated in cases of cellulitis and 10% of patients with this condition will also have diabetes that is either known or unmasked by the infection [65].…”

Section: Skin Nail Mucous Membrane and Soft Tissue Infectionsmentioning

confidence: 99%

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

Peleg

Weerarathna

McCarthy

et al. 2006

Diabetes Metabolism Res

507

406

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SummarySpecific defects in innate and adaptive immune function have been identified in diabetic patients in a range of in vitro studies. However, the relevance of these findings to the integrated response to infection in vivo remains unclear, especially in patients with good glycaemic control. Vaccine efficacy seems adequate in most diabetic patients, but those with type 1 diabetes and high glycosylated haemoglobin levels are most likely to exhibit hyporesponsiveness. While particular infections are closely associated with diabetes, this is usually in the context of extreme metabolic disturbances such as ketoacidosis. The link between glycaemic control and the risk of common community-acquired infections is less well established but could be clarified if infection data from large community-based observational or intervention studies were available. The relationship between hospital-acquired infections and diabetes is well recognized, particularly among post-operative cardiac and critically ill surgical patients in whom intensive insulin therapy improves clinical outcome independent of glycaemia. Nevertheless, further research is needed to improve our understanding of the role of diabetes and glycaemic control in the pathogenesis and management of community-and hospitalacquired infections.

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“…Only nine of our patients had neither of these lesions. These usual precursors of a cellulitis attack are more common in the lower limb 2,4,9,17,18,22 . Cellulitis develops in 20% of those with primary lymphoedema 1 2 and in our experience may be the first manifestation.…”

Section: Discussionmentioning

confidence: 99%

Eighty-five consecutive cases of cellulitis: clinical features, management and implications for hospital care

Butcher¹,

Papworth²,

Parvin³

et al. 2003

Phlebology

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Objectives: To determine lessons learned from a consecutive series of patients admitted with cellulitis, regarding factors leading to admission, management and duration of hospitalization. Methods: Prospective data over a 12-month period within a district general hospital. Centralized admitting policy of all patients with a principle diagnosis of cellulitis under the vascular surgical department. Data comparison of younger patients vs older and of those hospitalized for less than one week vs more than one week. Results: Of 85 patients admitted, 44 had previous oedema and 50 had a skin lesion as a portal for entry of infection; only nine had neither prior to the attack. Thirty-two had had at least one previous attack of cellulitis. Younger patients tended to have a more virulent systemic infection whereas older patients had more comorbidity and social problems. Fourteen patients required surgical intervention: eight had arterial and six had venous contributory circulatory disorders. Microbiological information was of minimal practical value. Surgical intervention and social problems were associated with delayed discharge. Conclusions: The majority of patients with cellulitis had predisposing oedema/skin lesions and where these persisted or recurrent infection occurred long-term antibiotic prophylaxis may have been useful. Social problems and comorbidity remained complicating factors but more patients could probably have been managed in a domiciliary setting.

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Cellulite and the Occult Diabetic

Cited by 5 publications

References 16 publications

Comorbidities as Risk Factors for Acute and Recurrent Erysipelas

Comorbidities as Risk Factors for Acute and Recurrent Erysipelas

Common infections in diabetes: pathogenesis, management and relationship to glycaemic control

Eighty-five consecutive cases of cellulitis: clinical features, management and implications for hospital care

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