The Prevalence of Cutaneous Manifestations in IDDM Patients and Their Association With Diabetes Risk Factors and Microvascular Complications

Yosipovitch, Gil; Hodak, Emmilia; Vardi, Pnina; Shraga, I.; Karp, M; Sprecher, Elliot; David, Michael

doi:10.2337/diacare.21.4.506

Cited by 156 publications

(145 citation statements)

References 24 publications

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“…This disorder showed, in a stepwise logistic regression analysis, a highly significant association with ichthyosiform skin changes. This is in line with findings of the Israeli group (3,20) linking keratosis pilaris to a high BMI, dry skin, and atopic eczema. In our series, only one patient had atopic eczema, and, unfortunately, we did not calculate the BMI of our patients.…”

Section: Results -supporting

confidence: 74%

“…We have not observed many other skin disorders associated with diabetes, such as generalized thick skin, diabetic dermopathy, yellow hands, acanthosis nigricans, granuloma annulare, multiple skin tags, or ulcers. The most likely explanation is the relatively short duration of diabetes in our pediatric and adolescent patients with type 1 diabetes compared with previous cross-sectional studies (2,3).…”

Section: Results -mentioning

confidence: 73%

“…It seems that scleroiderma-like lesions of the hand are a late complication of type 1 diabetes, at least if compared with ichthyosiform skin changes. Advanced glycosylation is believed to underlie the connective tissue changes in this disorder (3,11).…”

Section: Results -mentioning

confidence: 99%

“…hough it is well known that diabetes is associated with a number of cutaneous manifestations (1)(2)(3), there is a relative paucity of studies looking at the prevalence of skin changes in young patients with type 1 diabetes. Cutaneous manifestations generally appear subsequent to the development of diabetes but may be the first presenting sign or even precede the diagnosis by many years.…”

mentioning

confidence: 99%

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The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

et al. 2007

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OBJECTIVE -The aim of the study was to assess the prevalence of cutaneous disorders and their relation to disease duration, metabolic control, and microvascular complications in children and adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODS -The presence and frequency of skin manifestations were examined and compared in 212 unselected type 1 diabetic patients (aged 2-22 years, diabetes duration 1-15 years) and 196 healthy sex-and age-matched control subjects.Logistic regression was used to analyze the relation of cutaneous disorders with diabetes duration, glycemic control, and microvascular complications.RESULTS -One hundred forty-two (68%) type 1 diabetic patients had at least one cutaneous disorder vs. 52 (26.5%) control subjects (P Ͻ 0.01). Diabetes-associated skin lesions were found in 81 (38%) patients. Acquired ichthyosis, rubeosis faciei, diabetic hand, and necrobiosis lipoidica were seen in 22 vs. 3%, 7.1 vs. 0%, 2.3 vs. 0%, and 2.3 vs. 0% of type 1 diabetic and control subjects, respectively. The frequency of cutaneous reactions to insulin therapy was low (-2.7%). The prevalence of fungal infections in patients and control subjects was 4.7% and 1.5%, respectively. Keratosis pilaris affected 12% of our patients vs. 1.5% of control subjects. Diabetic hand was strongly (odds ratio 1.42 [95% CI 1.11-1.81]; P Ͻ 0.001), and rubeosis faciei weakly (1.22 [1.04 -1.43]; P ϭ 0.0087), associated with diabetes duration. Significant association was also found between acquired ichthyosis and keratosis pilaris (1.53 [1.09 -1.79]; P Ͻ 0.001).CONCLUSIONS -Cutaneous manifestations are common in type 1 diabetic patients, and some of them, like acquired ichthyosis and keratosis pilaris, develop early in the course of the disease. Diabetic hand and rubeosis faciei are related to disease duration. Diabetes Care 30:1964-1967, 2007T hough it is well known that diabetes is associated with a number of cutaneous manifestations (1-3), there is a relative paucity of studies looking at the prevalence of skin changes in young patients with type 1 diabetes. Cutaneous manifestations generally appear subsequent to the development of diabetes but may be the first presenting sign or even precede the diagnosis by many years. The cutaneous findings can be classified into four major groups: 1) skin diseases associated with diabetes, such as scleroderma-like changes of the hand, necrobiosis lipoidica, and diabetic dermopathy; 2) cutaneous infections; 3) cutaneous manifestations of diabetes complications, such as neuropathic foot ulcers; and 4) skin reactions to diabetes treatment (1).To understand the development of skin lesions and their relationship to diabetes complications, a useful approach would be a long-term follow-up of type 1 diabetic patients and/or surveys of cutaneous disorders in younger type 1 diabetic subjects. Available data suggest that skin dryness and scleroderma-like changes of the hand represent the most common cutaneous manifestations of type 1 diabetes seen in up to 49% of the patients (3). They are interrel...

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Section: Results -supporting

confidence: 74%

Section: Results -mentioning

confidence: 73%

Section: Results -mentioning

confidence: 99%

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confidence: 99%

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The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

et al. 2007

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“…6 It is noted that factors such as stratum corneum adhesion and accelerated aging of the skin may be implicated in the development of ichtyosiform skin changes in Type I DM patients and it could be explained by structural changes in skin proteins due to advance glycosylations. 3 There is strong correlation between ichthyoiform skin changes and diabetic retinopathy suggesting microvascular involvement in the pathogenesis of skin changes. 3,7 Further observation will be needed in order to evaluate whether these lesions will progress to the full spectrum of the Limited Joint Mobility syndrome and represent an early risk marker for the development of diabetes complications.…”

Section: Case Reportmentioning

confidence: 99%

Scleroderma-like skin changes not involving the hand in a prepubertal male with type I diabetes mellitus

Pitukcheewanont

Bali²,

Somanunt³

et al. 2011

Dermato-Endocrinology

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Migratory Ichthyosiform Dermatosis With Type 2 Diabetes Mellitus and Insulin Resistance

et al. 1999

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The Prevalence of Cutaneous Manifestations in IDDM Patients and Their Association With Diabetes Risk Factors and Microvascular Complications

Abstract: Acquired ichthyosis is a common finding and the most prevalent skin manifestation in young IDDM patients. The development of several skin manifestations in insulin-dependent patients seems to be related to duration of diabetes and to development of diabetic microvascular complications.

Cited by 156 publications

References 24 publications

The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

Scleroderma-like skin changes not involving the hand in a prepubertal male with type I diabetes mellitus

Migratory Ichthyosiform Dermatosis With Type 2 Diabetes Mellitus and Insulin Resistance

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