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.
Similar content being viewed by others
References
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.
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.
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.
Ngo BT, Hayes KD, DiMiao DJ, et al. Manifestations of cutaneous diabetic microangiopathy. Am J Clin Dermatol. 2005;6:225–37.
Goyal A, Raina S, Kaushal SS, et al. Pattern of cutaneous manifestation in diabetes mellitus. Indian J Dermatol. 2010;55:39–41.
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.
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.
Foss NT, Polon MH, Takada MH, et al. Skin lesions in diabetic patients. Rev Saude Publica. 2005;39:677–829.
Levy L, Zeichner JA. Dermatologic manifestation of diabetes. J Diabetes. 2012;4:68–76.
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.
Al-Mutairi N, Zaki A, Sharma AK, Al-Sheltawi M. Cutaneous manifestations of diabetes mellitus. Med Princ Pract. 2006;15:427–30.
Abdollahi A, Daneshpazhooh M, Amirchaghmaghi E, et al. Dermopathy and retinopathy in diabetes: is there an association? Dermatology. 2007;214:133–6.
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.
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.
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.
Wohlrab J, Wohlrab D, Meiss F. Skin diseases in diabetes mellitus. J Dtsch Dermatol Ges. 2007;5:37–53.
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.
Shemer A, Bergman R, Linn S, et al. Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol. 1998;37:113–5.
Kiziltan ME, Benbir G. Clinical and nerve conduction studies in female patients with diabetic dermopathy. Acta Diabetol. 2008;45:97–105.
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
Corresponding author
Rights 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
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40257-013-0048-2