Skip to main content
Log in

Relationship Between Skin Diseases and Extracutaneous Complications of Diabetes Mellitus: Clinical Analysis of 750 Patients

  • Original Research Article
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background

The relationship between skin diseases and extracutaneous complications in diabetes mellitus (DM) is unclear.

Objective

We aimed to investigate the relationship between skin disorders and diabetic neuropathy, nephropathy, and retinopathy in patients with DM.

Methods

A total of 750 patients with DM were prospectively enrolled. Demographic and clinical features, skin disorders, glycosylated hemoglobin (HbA1c) levels, and presence of nephropathy, neuropathy, and retinopathy were noted.

Results

Of the patients, 38.0 % had neuropathy, 23.3 % had nephropathy, and 22.9 % had retinopathy. Any skin disorder was present in 79.2 % (n = 594) of patients. The most common skin manifestations were cutaneous infections (47.5 %), xerosis (26.4 %), and inflammatory skin diseases (20.7 %). The frequency of cutaneous infections, fungal infections, diabetic foot, rubeosis faciei, and pigmented purpuric dermatitis was higher in patients with nephropathy than in those without nephropathy. Cutaneous infections, diabetic foot, rubeosis faciei, and diabetic dermopathy were more common in patients with neuropathy. Fungal infections, diabetic foot, rubeosis faciei, diabetic dermopathy, and pigmented purpuric dermatitis were more frequent in patients with retinopathy. Patients with HbA1c ≥8 mmol/mL had more skin disorders than those with HbA1c <8 mmol/mL (P < 0.05 for all).

Conclusion

Skin disorders may be clues to the presence of associated microvascular complications of DM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Shahzad M, Al Robaee A, Al Shobaili HA, et al. Skin manifestations in diabetic patients attending a diabetic clinic in the Qassim region, Saudi Arabia. Med Princ Pract. 2011;20:137–41.

    Article  PubMed  Google Scholar 

  2. Romano G, Moretti G, Di Benedetto A, et al. Skin lesions in diabetes mellitus: prevalence and clinical correlations. Diabetes Res Clin Pract. 1998;39:101–6.

    Article  CAS  PubMed  Google Scholar 

  3. Hosseini MS, Ehsani AH, Panah FH, Azizi F. The correlation between skin lesions, microabluminuria and other microvascular complications in type 2 diabetic patients. Int J Nephrol Urol. 2010;2:553–60.

    Google Scholar 

  4. Ngo BT, Hayes KD, DiMiao DJ, et al. Manifestations of cutaneous diabetic microangiopathy. Am J Clin Dermatol. 2005;6:225–37.

    Article  PubMed  Google Scholar 

  5. Goyal A, Raina S, Kaushal SS, et al. Pattern of cutaneous manifestation in diabetes mellitus. Indian J Dermatol. 2010;55:39–41.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Tai TY, Tseng CH, Sung SM, et al. Retinopathy, neuropathy and nephropathy in non-insulin-dependent diabetic patients. J Formos Med Assoc. 1991;90:936–40.

    CAS  PubMed  Google Scholar 

  7. Chang SJ, Hsu SC, Tien KJ, et al. Metabolic syndrome associated with toenail onychomycosis in Taiwanese with diabetes mellitus. Int J Dermatol. 2008;47:467–72.

    Article  CAS  PubMed  Google Scholar 

  8. Foss NT, Polon MH, Takada MH, et al. Skin lesions in diabetic patients. Rev Saude Publica. 2005;39:677–829.

    Article  CAS  PubMed  Google Scholar 

  9. Levy L, Zeichner JA. Dermatologic manifestation of diabetes. J Diabetes. 2012;4:68–76.

    Article  PubMed  Google Scholar 

  10. Sasmaz S, Buyukbese MA, Cetinkaya A, et al. The prevalence of skin disorders in type-2 diabetic patients. Internet J Dermatol. 2004;3(1). doi:10.5580/15ba.

  11. Al-Mutairi N, Zaki A, Sharma AK, Al-Sheltawi M. Cutaneous manifestations of diabetes mellitus. Med Princ Pract. 2006;15:427–30.

    Article  PubMed  Google Scholar 

  12. Abdollahi A, Daneshpazhooh M, Amirchaghmaghi E, et al. Dermopathy and retinopathy in diabetes: is there an association? Dermatology. 2007;214:133–6.

    PubMed  Google Scholar 

  13. Patidar PP, Ramachandra P, Philip R, et al. Correlation of acanthosis nigricans with insulin resistance, anthropometric, and other metabolic parameters in diabetic Indians. Indian J Endocrinol Metab. 2012;16(Suppl 2):436–77.

    Google Scholar 

  14. Gupta AK, Konnikov N, MacDonald P, et al. Prevalence and epidemiology of toenail onychomycosis in diabetic subjects a multicentre survey. Br J Dermatol. 1998;139:665–71.

    Article  CAS  PubMed  Google Scholar 

  15. Paul C, Maumus-Robert S, Mazereeuw-Hautier J, et al. Prevalence and risk factors for xerosis in the elderly: a cross-sectional epidemiological study in primary care. Dermatology. 2011;223:260–5.

    Article  CAS  PubMed  Google Scholar 

  16. Wohlrab J, Wohlrab D, Meiss F. Skin diseases in diabetes mellitus. J Dtsch Dermatol Ges. 2007;5:37–53.

    Article  PubMed  Google Scholar 

  17. Pavlović MD, Milenković T, Dinić M, et al. The prevalence of cutaneous manifestations in young patients with type 1 diabetes. Diabetes Care. 2007;30:1964–7.

    Article  PubMed  Google Scholar 

  18. Shemer A, Bergman R, Linn S, et al. Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol. 1998;37:113–5.

    Article  CAS  PubMed  Google Scholar 

  19. Kiziltan ME, Benbir G. Clinical and nerve conduction studies in female patients with diabetic dermopathy. Acta Diabetol. 2008;45:97–105.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

No sources of funding were used to conduct this study or prepare this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Duriye Deniz Demirseren.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Demirseren, D.D., Emre, S., Akoglu, G. et al. Relationship Between Skin Diseases and Extracutaneous Complications of Diabetes Mellitus: Clinical Analysis of 750 Patients. Am J Clin Dermatol 15, 65–70 (2014). https://doi.org/10.1007/s40257-013-0048-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40257-013-0048-2

Keywords

Navigation