Cutaneous Manifestations of Nutritional Excess: Pathophysiologic Effects of Hyperglycemia and Hyperinsulinemia on the Skin

Svoboda, Steven A; Shields, Bridget E.

doi:10.12788/cutis.0173

Cited by 10 publications

(7 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Bullosis diabeticorum, also known as diabetic bullae, is a rare complication of type 1 or 2 diabetes that results in spontaneous, noninflammatory blistering, most often affecting the lower extremities. Although the prevalence of bullosis diabeticorum is unknown, in small retrospective studies the annual incidence among patients with diabetes has been estimated at 0.16% to 0.5% . It is more common in males and often associated with long-standing peripheral neuropathy …”

Section: Discussionmentioning

confidence: 99%

“…Although the prevalence of bullosis diabeticorum is unknown, in small retrospective studies the annual incidence among patients with diabetes has been estimated at 0.16% to 0.5%. 3 It is more common in malesandoftenassociatedwithlong-standingperipheralneuropathy. 4 The pathophysiology of bullosis diabeticorum is unclear and may be multifactorial.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Patient With Diabetes and Spontaneous Blistering of the Right Lower Extremity

DeWane

Kroshinsky

2023

JAMA

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Patient With Diabetes and Spontaneous Blistering of the Right Lower Extremity

DeWane

Kroshinsky

2023

JAMA

View full text Add to dashboard Cite

show abstract

“…As mentioned, diabetic patients may display a well-known palette of skin complications due to persistent high levels of blood glucose, infections, anomalies of immunity, and chronic inflammation (for instance, necrobiosis lipoidica, diabetic dermopathy, scleroderma diabeticorum, acrochordons, keratosis pilaris, bullosis diabeticorum, and granuloma annulare) [ 147 , 148 , 149 , 150 , 151 , 152 ].…”

Section: Discussionmentioning

confidence: 99%

Acanthosis Nigricans: Pointer of Endocrine Entities

et al. 2022

View full text Add to dashboard Cite

Acanthosis nigricans (AN) has been reported in relation to insulin resistance (IR). We aim to review AN through an endocrine and metabolic perspective focusing on IR in association with metabolic complications such as obesity, diabetes mellitus (DM), and metabolic syndrome (MS) with/without polycystic ovary syndrome (PCOS). We revised English papers on PubMed covering publications from the last 5 years. The current prevalence of AN varies from 4.5 to 74% (or even 100%, depending on the studied population), with equal distribution among females and males. Despite higher incidence with an age-dependent pattern, an alarming escalation of cases has been noted for obesity and MS in younger populations . Most frequent IR-associated sites are the neck, axilla, and knuckles, but unusual locations such as the face have also been reported. Quantitative scales such as Burke have been used to describe the severity of the dermatosis, particularly in correlation with IR elements. Dermoscopic examination are required, for instance, in cases with sulcus cutis, hyperpigmented spots, crista cutis, and papillary projections. A skin biopsy may be necessary, but it is not the rule. Both IR that clinically manifests with or without obesity/MS correlates with AN; most studies are cross-sectional, with only a few longitudinal. The approach varied from screening during school periodic checkups/protocols/programs to subgroups of individuals who were already known to be at high cardio-metabolic risk. AN was associated with type2DM, as well as type 1DM. Females with PCOS may already display metabolic complications in 60–80% of cases, with AN belonging to the associated skin spectrum. AN management depends on underlying conditions, and specific dermatological therapy is not generally required, unless the patient achieves metabolic control, has severe skin lesions, or desires cosmetic improvement. In IR cases, lifestyle interventions can help, including weight control up to bariatric surgery. In addition, metformin is a key player in the field of oral medication against DM type 2, a drug whose indication is extended to PCOS and even to AN itself, outside the specific panel of glucose anomalies. In terms of cosmetic intervention, limited data have been published on melatonin, urea cream, topical retinoids, vitamin D analogs, or alexandrite laser. In conclusion, awareness of IR and its associated clinical features is essential to provide prompt recognition of underlying conditions. AN represents a useful non-invasive surrogate marker of this spectrum in both children and adults. The pivotal role of this dermatosis could massively improve endocrine and metabolic assessments.

show abstract

“…Increased levels of insulin also stimulate androgen production and can reduce serum levels of sex hormone-binding globulin (SHBG), consequently strongly enhancing androgen activity and favoring acne development [ 221 ]. Hyperandrogenemia resulting from elevated insulin levels contributes to excessive keratinocyte proliferation of the pilosebacious unit of hair follicles, which may account for the increased incidence of keratosis pilaris in individuals with insulin resistance [ 222 ].…”

Section: Non-metabolic Complications Of Obesity In Childrenmentioning

confidence: 99%

Not Only Metabolic Complications of Childhood Obesity

Ciężki,

Odyjewska,

Bossowski

et al. 2024

Nutrients

View full text Add to dashboard Cite

The increasing incidence of obesity in the pediatric population requires attention to its serious complications. It turns out that in addition to typical, well-known metabolic complications, obesity as a systemic disease carries the risk of equally serious, although less obvious, non-metabolic complications, such as cardiovascular diseases, polycystic ovary syndrome, chronic kidney disease, asthma, thyroid dysfunction, immunologic and dermatologic conditions, and mental health problems. They can affect almost all systems of the young body and also leave their mark in adulthood. In addition, obesity also contributes to the exacerbation of existing childhood diseases. As a result, children suffering from obesity may have a reduced quality of life, both physically and mentally, and their life expectancy may be shortened. It also turns out that, in the case of obese pregnant girls, the complications of obesity may also affect their unborn children. Therefore, it is extremely important to take all necessary actions to prevent the growing epidemic of obesity in the pediatric population, as well as to treat existing complications of obesity and detect them at an early stage. In summary, physicians treating a child with a systemic disease such as obesity must adopt a holistic approach to treatment.

show abstract

Cutaneous Manifestations of Nutritional Excess: Pathophysiologic Effects of Hyperglycemia and Hyperinsulinemia on the Skin

Abstract: • Early recognition and management of these cutaneous conditions can help maximize patient quality of life and avoid long-term sequelae associated with insulin resistance and prolonged hyperglycemia.

Cited by 10 publications

References 65 publications

A Patient With Diabetes and Spontaneous Blistering of the Right Lower Extremity

A Patient With Diabetes and Spontaneous Blistering of the Right Lower Extremity

Acanthosis Nigricans: Pointer of Endocrine Entities

Not Only Metabolic Complications of Childhood Obesity

Contact Info

Product

Resources

About