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Dermatological Issues in a Child with Diabetes Mellitus

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Pediatric Diabetes

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Abstract

It is now a well-recognized fact that diabetes mellitus (DM) is associated with cutaneous manifestations1-4. Cutaneous manifestations in DM are estimated to occur at a frequency of at least 30% to 70%, but with increasing awareness of the various cutaneous manifestations of DM, it may even approach almost 100%4. The spectrum of skin diseases in DM are numerous and diverse. These conditions can range from benign conditions to life threatening conditions with bad consequences. Some are pathognomonic for DM; yet some are weakly associated with diabetes. Others are a result of the complications or treatment of DM. Sometimes the skin condition may precede the diagnosis of DM, but most often appear after the diagnosis of DM. Regardless of all of these, it is important for the clinician to recognize the cutaneous manifestations of DM so that treatment and /or prevention can be instituted appropriately. This chapter will address the dermatological issues that can present in a child with diabetes. Table 1 is an outline of the major skin disorders associated with DM in children and adolescents.

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References

  1. Edidin, D.V. Cutaneous manifestations of diabetes mellitus in children. Pediatr Dermatol 1985; 2, 161–179.

    Article  PubMed  CAS  Google Scholar 

  2. Jelinek, I.E. Cutaneous manifestations of diabetes mellitus. Int J Derm 1994; 33, 605–617.

    Article  PubMed  CAS  Google Scholar 

  3. Perez, M.I., and Kohn, S.R. Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol 1994; 30, 519–529.

    Article  PubMed  CAS  Google Scholar 

  4. Sibbald, R.G., Landolt, S.J., and Toth, D. Skin and Diabetes. Endocrino Metab Clin North Am 1996; 25, 463–472.

    Article  CAS  Google Scholar 

  5. Rosenbloom, A.L., and Frias, J.L. Diabetes, short stature and joint stiffness — a new syndrome. Clin Res 1974; 22, 92A.

    Google Scholar 

  6. Starkinan, H., and Brink, S. Limited joint mobility of the hand in type I diabetes mellitus. Diabetes Care 1982; 5, 534–536.

    Article  Google Scholar 

  7. Grgic, A., Rosenbloom, A.L., Weber, F.T., Giordano, B., Malone, J.L, and Shuster, JJ. Joint contracture-common manifestation of childhood diabetes mellitus. J Pediatr 1976; 88, 584–588.

    Article  PubMed  CAS  Google Scholar 

  8. Seibold, J.R. Digital sclerosis in children with insulin dependent diabetes mellitus. Arthritis Rheum 1982; 25, 1357–1361.

    Article  PubMed  CAS  Google Scholar 

  9. Heathcote, J.G., Cohen, H., and Noble, J. Dupuytren’s disease and diabetes mellitus. Lancet 1981; 1; 1420.

    Article  PubMed  CAS  Google Scholar 

  10. Buckingham, B.A., Uitto, J., Sandborg, C., Keens, T., Kaugman, F., and Landing, B. Scleroderma-like syndrome and the non-enzymatic glycosylation of collagen in children with poorly controlled insulin-dependent diabetes (IDDM). Pediatr Res 1981; 15, 626.

    Article  Google Scholar 

  11. Friedman, N.E., Levitsky, L.L., Edidin, D.V., Vitullo, D.A., Lascina, J.J., and Chiemming-Kottip, P. Echocardiographic evidence for impaired myocardial performance in children with type I diabetes mellitus. Am J. Med 1982; 173, 846–850.

    Article  Google Scholar 

  12. Savin, J.A. Bacterial infections in diabetes mellitus. Br J Dermatol 1974; 91, 481–487.

    Article  PubMed  CAS  Google Scholar 

  13. Lyons, T.J., and Kennedy, L. Non-enzymatic glycosylation of skin collagen in patients with type I (insulin-dependent) diabetes mellitus and limited joint mobility. Diabetologia 1985; 28(2-5).

    Article  PubMed  CAS  Google Scholar 

  14. Rosenbloom, A.L., Silverstein, J.H., Lezotte, D.C., Richardson, K., and McCallum, M. Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease. N Engl J Med 1981; 305, 191–194.

    Article  PubMed  CAS  Google Scholar 

  15. Lieberman, L.A., Rosenbloom, A.L., Riley, W.J., and Silverstein, J.H. Correlated changes in skin thickness and glycosylated hemoglobin with pump administration of insulin. Clin Res 1980; 28, 866A.

    Google Scholar 

  16. Muller, S.A., and Winkelmann, R.K. Necrobiosis lipoidica diabeticorum. Results of glucose tolerance tests in nondiabetic patients. JAMA 1961; 119; 139–142.

    Google Scholar 

  17. Lowitt, M.H., and Dover, J.S. Necrobiosis lipoidica. J Am Acad Dermatol 1991; 25, 735–748.

    Article  PubMed  CAS  Google Scholar 

  18. Boulton, A.J.M., Cutfield, R.G., Abouganem, D. et al. Necrobiosis lipoidica diabeticorum: A clinicopathologic study. J Am Acad Dermatol 1988; 18, 530–537.

    Article  PubMed  CAS  Google Scholar 

  19. Stratham, B., Finlay, A.Y., and Marks, R. A randomized double-blind comparison of aspirin-dipyramidole combination vs placebo in the treatment of necrobiosis lipoidica. Acta Dermatol Venereol 1981; 61; 270–271.

    Google Scholar 

  20. Dubin, B J., and Kaplan, E.N. The surgical treatment of necrobiosis lipoidica diabeticorum. Plast Reconstr Surg 1977; 60, 421–427.

    PubMed  CAS  Google Scholar 

  21. Huntley, A.C. The cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol 1982; 7, 427–455.

    Article  PubMed  CAS  Google Scholar 

  22. Boyd, S.G., Innes, S.M., and Campbell, LW. Skin manifestations of diabetes mellitus. Practitioner 1982; 226, 253–264.

    PubMed  CAS  Google Scholar 

  23. Binkley, G.W. Dermopathy in diabetes mellitus. Arch Dermatol 1965; 92, 106–107.

    Article  Google Scholar 

  24. Danowski, T.S., Sabeh, G., Sarver, M.E., Shelkrot, J. and Fisher, E.R. Shin spots and diabetes mellitus. Am J Med Sci 1966; 251, 570–575.

    Article  PubMed  CAS  Google Scholar 

  25. Binkley, G.W., Giraldo, B., and Stoughton, K.B. Diabetic dermopathy — A clinical study. Cutis 1967; 3, 955–958.

    Google Scholar 

  26. Fisher, E.R., and Danowski, T.S. Histologic histochemical and electron microscopic features of the shin spots of diabetes mellitus. Am J Clin Path 1968; 50, 547–554.

    PubMed  CAS  Google Scholar 

  27. Haim, S., Friedman-Birnbaum, R., Shafir, A. Generalized granuloma annulare:relationshipto diabetes mellitus as revealed in 8 cases. Br J Dermatol 1970; 83, 302–305.

    Article  PubMed  CAS  Google Scholar 

  28. Dicken, C.H., Carrington, S.G., and Winkelmann, R.K. Generalized granuloma annulare. Arch Dermatol 1969; 99, 556–563.

    Article  PubMed  CAS  Google Scholar 

  29. Edwards, J.E., Tillman, D.B., Miller, M.E. et al. Infection and diabetes mellitus. West J Med 1979; 130, 515–521.

    Google Scholar 

  30. Kimmerly, S.A. Dermatologic manifestations of infections in diabetics. Infect Dis Clin of North Am 1994; 8, 523–532.

    Google Scholar 

  31. Moutschen, M.P., Scheen, A.J., and Lefevre, PJ. Impaired immune responses in diabetes mellitus: analysis of the factors and mechanisms involved. Relevance to the increased susceptibility of diabetic patients to specific infections. Diabet Metab 1992; 18, 187–201.

    CAS  Google Scholar 

  32. Sonck, C.E., and Somersalo, O. The yeast flora of the anogenital region in diabetic girls. Arch Dermatol 1963; 88, 846–852.

    Article  PubMed  CAS  Google Scholar 

  33. Knight, L., and Fletcher, J. Growth of Candida albicans in saliva: Stimulation by glucose associated with antibiotics, corticosteroids, and diabetes mellitus. J Infect Dis 1971; 123, 371–377.

    Article  PubMed  CAS  Google Scholar 

  34. Alteras, I, and Saryt, E. Prevalence of pathogenic fungi in the toewebs and toenails of diabetic patients. Mycopathologia 1979; 67, 157–159.

    Article  PubMed  CAS  Google Scholar 

  35. Ryan-Poirier, K., Eiseman, R.M., Beaty, J.H., Hunt, P.G., Burghen, G.A., and Leggidro, RJ. Post-traumatic cutaneous mucormycosis in diabetes meliitus. Clin Pediatr 1988; 27, 609–612.

    Article  CAS  Google Scholar 

  36. Tomford, J.W., Whittlesey, D., Ellner, J.J., Tomashefski, J.F. Invasive primary cutaneous phycomycosis in diabetic leg ulcers. Arch Surg 1980; 115, 770–771.

    Article  PubMed  CAS  Google Scholar 

  37. Limongelli, W.A., Clark, M.S., Jaglimbene, R., Baden, E., Washington, J.A., and Williams, A.C. Successful treatment of mucocutaneous mucormycosis after dental extraction in a patient with uncontrolled diabetes. J Oral Surg 1975; 33, 705–712.

    PubMed  CAS  Google Scholar 

  38. Lipsky, B.A., Pecoraro, R.E., Chen, M.S. et al. Factors affecting staphylococcal colonization among NIDDM outpatients. Diabetes Care 1987; 10, 483–486.

    Article  PubMed  CAS  Google Scholar 

  39. Menitt, W.T., Bass, J.W., and Brahn, F.W. Malignant external otitis in an adolescent with diabetes. J Pediatr 1980; 96, 872–873.

    Article  Google Scholar 

  40. Joachims, H.Z. Malignant external otitis in children. Arch Otolaryngol 1976; 102, 236–237.

    Article  PubMed  CAS  Google Scholar 

  41. Haroon, T.S. Diabetes and skin – a review. Scot Med J 1974; 19, 257–267.

    PubMed  CAS  Google Scholar 

  42. Montes, L.F., Dobson, H., Dodge, B.G., and Knowles, W.R. Erythrasma and diabetes meliitus. Arch Dermatol 1969; 99, 674–680.

    Article  PubMed  CAS  Google Scholar 

  43. Kahn, C.R. The syndromes of insulin resistance and acanthosis nigricans: insulin receptor disorders in man. N Engl J Med 1976; 294, 736–745.

    Google Scholar 

  44. Stuart, C.A., Smith, M.M., Gilkison, C.R., Shaheb, S., and Stahn, R.M. Acanthosis Nigricans among native americans: an indicator of high diabetes risk. Am J Public Health 1994; 84, 1839–1842.

    Article  PubMed  CAS  Google Scholar 

  45. Cruz, P.D. Excess insulin binding to insulin-like growth factor receptors: Proposed mechanism for acanthosis nigricans. J Invest Dermatol 1992; 98 (suppl), 82S–85S.

    Article  PubMed  Google Scholar 

  46. Rosenberg, A.M., Haworth, J.C., Degroot, G.W., Trevenen, C.L., and Rechler, M.M. A case if leprechaunism with severe hyperinsulinemia. Am J Dis Child 1980; 134, 170–175.

    PubMed  CAS  Google Scholar 

  47. Lawrence, R.D. Lipodystrophy and hepatosplenomegaly with diabetes, lipaemia, and other metabolic disturbances. A case throwing new light on the action of insulin. Lancet 1946; 1, 724–731.

    Article  PubMed  Google Scholar 

  48. Hogan, P.A. “Cutaneous manifestations of endocrine diseases”. In Textbook of Pediatric Dermatology, Harper, J., Oranje, A., Prose, N., eds. Maiden, MA: Blackwell Science, Inc., 2000.

    Google Scholar 

  49. Torigoe, K., Numata, O., Yazaki, S., Hasegawa, S., Boku, N., Hiura, M., Ino, H., and Matsunaga, M. Sympathetic skin response in diabetic children: Do diabetic children have diabetic neuropathy? Pediatrics international 1999; 41, 631–636.

    Article  PubMed  CAS  Google Scholar 

  50. Palcy, R.G., and Turnbridge, R.E. Dermal reaction in insulin therapy. Diabetes 1952; 1, 22–27.

    Google Scholar 

  51. Kahn, C.R., and Rosenthal, A.S. Immunologic reactions to insulin, insulin allergy, insulin resistance and the autoimmune insulin syndrome. Diabetes Care 1979; 2, 283–295.

    PubMed  CAS  Google Scholar 

  52. Patterson, R„ Mellies, C.J., and Roberts, M. Immunologic reactions against insulin. II. IgE anti-insulin, insulin allergy and combined IgE and IgG immunologic insulin resistance. J Immunol 1973; 110, 1135–1145.

    CAS  Google Scholar 

  53. Johnson, D.A., and Parlette, H.Z. Insulin-induced hypertrophic lipodystrophy. Cutis 1983; 32, 273–275.

    PubMed  CAS  Google Scholar 

  54. Reeves, W.G., Allen, B.R., and Tattersall, R.B. Insulin induced lipoatrophy: evidence for an immune pathogenesis. Br Med J 1980; 280, 1500–1503.

    Article  PubMed  CAS  Google Scholar 

  55. Wright, A.D., Walsh, C.H., Fitzgerald, M.G., et al. Very pure porcine insulin in clinical practice. BMJ 1979; 1, 25–27.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Dermatology Nemours Children’s Clinic, Jacksonville, Fl, USA

    Pearl C. Kwong MD, PhD

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  1. Pearl C. Kwong MD, PhD
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Editors and Affiliations

  1. Division of Endocrinology, Metabolism & Diabetes C.S. Mott Children’s Hospital, University of Michigan Health System, Ann Arbor, MI, USA

    Ram K. Menon M.D.

  2. Division of Endocrinology, Metabolism & Diabetes Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Mark A. Sperling M.D.

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Kwong, P.C. (2003). Dermatological Issues in a Child with Diabetes Mellitus. In: Menon, R.K., Sperling, M.A. (eds) Pediatric Diabetes. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-0507-5_20

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  • DOI: https://doi.org/10.1007/978-1-4615-0507-5_20

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-5111-5

  • Online ISBN: 978-1-4615-0507-5

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