Dermatological Issues in a Child with Diabetes Mellitus
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.
KeywordsNeuropathy Triglyceride Hyperglycemia Erythromycin Amphotericin
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- 5.Rosenbloom, A.L., and Frias, J.L. Diabetes, short stature and joint stiffness — a new syndrome. Clin Res 1974; 22, 92A.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
- 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
- 25.Binkley, G.W., Giraldo, B., and Stoughton, K.B. Diabetic dermopathy — A clinical study. Cutis 1967; 3, 955–958.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.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
- 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
- 50.Palcy, R.G., and Turnbridge, R.E. Dermal reaction in insulin therapy. Diabetes 1952; 1, 22–27.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.Google Scholar