Cutaneous Manifestations Associated with Diabetes Mellitus—A Retrospective Study

Abstract

Diabetes mellitus (DM) is one of the world’s most important health problems, affecting more than half a billion of the world’s population today, with an ever-increasing prevalence. Among the most common manifestations of diabetes are skin manifestations, with 30–70% of patients experiencing skin complications during the course of the disease. Conditions such as acanthosis nigricans, diabetic dermopathy, necrobiosis lipoidica, bacterial infections, fungal infections, skin xerosis, and metabolic prurigo are often associated with diabetes and often precede its diagnosis. We conducted a retrospective study on a group of 103 patients hospitalized between January 2018 and December 2022, in a clinic of a county hospital, using as criteria the diagnosis of diabetes mellitus complicated by cutaneous manifestations frequently associated with diabetes. The aim was to observe which are the most common manifestations and whether they correlate with data in the research literature. In the present study, manifestations such as diabetic foot (20% of patients), bacterial (35%) and fungal infections, and cutaneous xerosis (45%) were predominant. Often, the integumentary involvement may precede the diagnosis of the underlying disease. It is therefore very important to recognize, investigate and treat these manifestations as soon as possible.

Diabetes mellitus and its skin manifestations - dermatology for diabetologists

“…Moreover, vascular disorders and diabetic polyneuropathy make patients less sensitive to pain, which, in the event of an injury, may lead to unawareness, causing infection and deepening of wounds. [2] Bacterial infections are often caused by Staphylococcus Aureus and Group Bhemolytic Streptococci. Staphylococcus aureus is responsible for conditions such as cellulitis, purulent skin infections, recurrent folliculitis, and infectious eczema.…”

“…Superficial vessels on the face dilate due to microcirculation disorders, leading to the formation of chronic bright red erythema on the cheeks and neck. [2] Treatment is mainly causal and involves regulating the patient's carbohydrate metabolism and avoiding caffeine and nicotine. [18] Sclerotic skin edema is a consequence of excessive collagen glycation due to hyperglycemia.…”

“…Other considered causes are the influence of UV radiation, microangiopathy, and disorders of calcium metabolism. [2] [10] [18] Diabetic dermopathy is well-defined brown spots, approximately 1 cm in size, with a central indentation. They are most commonly located on the shin bone but can also appear on the arms, thighs, calves, or abdomen.…”

“…Diagnosis, in most cases, should be limited to dermatoscopy; however, in some cases, a biopsy may be indicated to differentiate dark acanthosis from other discolorations. [2] [8] [17] Hidradenitis suppurativa (inverse acne) is a chronic inflammatory skin disease that begins in hair follicles and, in collaboration with bacterial infection, leads to the formation of painful inflammatory nodules, abscesses, and skin fistulas. It is most commonly located in areas where the skin rubs against itself, such as the underarms, breasts, and groin, but as the disease progresses, it can affect body regions such as the neck, limbs, or skin behind the ears.…”

“…However, little is said about skin-related complications, which develop in 30-70% of patients during the course of the disease. [2] It is essential to emphasize the role of early detection of skin changes associated with diabetes in expediting the diagnostic process and initiating hyperglycemia treatment as quickly as possible.…”