Dermatoses em pacientes com diabetes mellitus

Abstract

ObjectiveIt is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their relationship with metabolic control of diabetes. Methods A total of 403 diabetic patients, 31% type 1 and 69% type 2, underwent dermatological examination in an outpatient clinic of a university hospital. The endocrine-metabolic evaluation was carried out by an endocrinologist followed by the dermatological evaluation by a dermatologist. The metabolic control of 136 patients was evaluated using glycated hemoglobin. Results High number of dermophytosis (82.6%) followed by different types of skin lesions such as acne and actinic degeneration (66.7%), pyoderma (5%), cutaneous tumors (3%) and necrobiosis lipoidic (1%) were found. Among the most common skin lesions in diabetic patients, confirmed by histopathology, there were seen necrobiosis lipoidic (2 cases, 0.4%), diabetic dermopathy (5 cases, 1.2%) and foot ulcerations (3 cases, 0.7%). Glycated hemoglobin was 7.2% in both type 1 and 2 patients with adequate metabolic control and 11.9% and 12.7% in type 1 and 2 diabetic patients, respectively, with inadequate metabolic controls. A higher prevalence of dermatophytoses was seen in the both groups with inadequate metabolic control. ConclusionsThe results showed a high prevalence of skin lesions in diabetic patients, especially dermatophytoses. Thus, poor metabolic control of diabetes increases patient's susceptibility to skin infections.

Prevalence of Cutaneous Manifestations of Diabetes Mellitus

“…Diabetic dermopathy may develop from the factors that lead to the development of vascular complications of diabetes and it may serve as a clinical sign of an increased likelihood of vascular complications in diabetic patients. [20] Acanthosis nigricans was found in 4 % of patients, though Mashkoor et al [21] found acanthosis nigricans in 11% of patients which is almost three fold of our study. Pruritus was found in 4% of diabetic patients in our study.…”

Cutaneous Manifestations of Type-Ii Diabetes Mellitus

“…Another study conducted by Foss NT, et al, found highest number of dermatoptosis 82.6%, actinic degeneration 66.7%, pyoderma 5%, cutaneous tumor 3%, necrobiosis 1%, and diabetic dermopathy 1.2%. 9 Results of other study done by Naheed T, et al, found that 56% cases had bacterial infection, 48% had candidal infec- …”

A Descriptive Study- Cutaneous Manifestations of Diabetes

“…It has been suggested that a large number of dermatological problems in diabetes are caused by hyperglycaemia accelerated production of non-enzymatic advanced glycosylated end products. 1 Although prior studies showed increased risk of infection in DM patients, 6 little evidence is found in the literature to support increased risk for cutaneous infectious diseases. 7 In general, skin disorders are highly associated to poorly controlled DM patients.…”

“…Thus, the study demonstrated 94% of patients with inadequate glycaemia control had some skin disorders. 6 DM affects the skin through several mechanisms being hyperglycaemia per se and AGEs the most well described. Reaching pathological high levels of glycaemia strongly affects skin homeostasis by inhibiting keratinocyte proliferation and migration, protein biosynthesis, inducing endothelial cell apoptosis, decreasing nitric oxide synthesis and impairing phagocytosis and chemotaxis from several cells.…”