Functional properties of the stratum corneum in patients with diabetes mellitus: similarities to senile xerosis

Sakai, Shingo; Kikuchi, Katsuko; Satoh, Jo; Tagami, Hachiro; Inoue, Shintaro

doi:10.1111/j.1365-2133.2005.06756.x

Cited by 118 publications

(144 citation statements)

References 28 publications

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“…Despite possible definition discrepancies across the studies, it is clear that the skin dryness is one of the earliest and most common manifestations of type 1 diabetes. The clinical observations are supported by objective findings of a reduced hydration state of the stratum corneum and decreased sebaceous gland activity in patients with diabetes, without any impairment of the stratum corneum barrier function (6). Even in the absence of clinically apparent xerosis, patients with diabetes have an impaired desquamation process (7).…”

Section: Results -supporting

confidence: 59%

The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

et al. 2007

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OBJECTIVE -The aim of the study was to assess the prevalence of cutaneous disorders and their relation to disease duration, metabolic control, and microvascular complications in children and adolescents with type 1 diabetes.RESEARCH DESIGN AND METHODS -The presence and frequency of skin manifestations were examined and compared in 212 unselected type 1 diabetic patients (aged 2-22 years, diabetes duration 1-15 years) and 196 healthy sex-and age-matched control subjects.Logistic regression was used to analyze the relation of cutaneous disorders with diabetes duration, glycemic control, and microvascular complications.RESULTS -One hundred forty-two (68%) type 1 diabetic patients had at least one cutaneous disorder vs. 52 (26.5%) control subjects (P Ͻ 0.01). Diabetes-associated skin lesions were found in 81 (38%) patients. Acquired ichthyosis, rubeosis faciei, diabetic hand, and necrobiosis lipoidica were seen in 22 vs. 3%, 7.1 vs. 0%, 2.3 vs. 0%, and 2.3 vs. 0% of type 1 diabetic and control subjects, respectively. The frequency of cutaneous reactions to insulin therapy was low (-2.7%). The prevalence of fungal infections in patients and control subjects was 4.7% and 1.5%, respectively. Keratosis pilaris affected 12% of our patients vs. 1.5% of control subjects. Diabetic hand was strongly (odds ratio 1.42 [95% CI 1.11-1.81]; P Ͻ 0.001), and rubeosis faciei weakly (1.22 [1.04 -1.43]; P ϭ 0.0087), associated with diabetes duration. Significant association was also found between acquired ichthyosis and keratosis pilaris (1.53 [1.09 -1.79]; P Ͻ 0.001).CONCLUSIONS -Cutaneous manifestations are common in type 1 diabetic patients, and some of them, like acquired ichthyosis and keratosis pilaris, develop early in the course of the disease. Diabetic hand and rubeosis faciei are related to disease duration. Diabetes Care 30:1964-1967, 2007T hough it is well known that diabetes is associated with a number of cutaneous manifestations (1-3), there is a relative paucity of studies looking at the prevalence of skin changes in young patients with type 1 diabetes. Cutaneous manifestations generally appear subsequent to the development of diabetes but may be the first presenting sign or even precede the diagnosis by many years. The cutaneous findings can be classified into four major groups: 1) skin diseases associated with diabetes, such as scleroderma-like changes of the hand, necrobiosis lipoidica, and diabetic dermopathy; 2) cutaneous infections; 3) cutaneous manifestations of diabetes complications, such as neuropathic foot ulcers; and 4) skin reactions to diabetes treatment (1).To understand the development of skin lesions and their relationship to diabetes complications, a useful approach would be a long-term follow-up of type 1 diabetic patients and/or surveys of cutaneous disorders in younger type 1 diabetic subjects. Available data suggest that skin dryness and scleroderma-like changes of the hand represent the most common cutaneous manifestations of type 1 diabetes seen in up to 49% of the patients (3). They are interrel...

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Section: Results -supporting

confidence: 59%

The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

et al. 2007

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“…However, our study shows more incidence of xerosis. The clinical observations are supported by objective findings of a reduced hydration state of the stratum corneum and decreased sebaceous gland activity in patients with diabetes, without any impairment of the stratum corneum barrier function [19]. The third commonest finding, vitiligo was found in 8% of the studied patients.…”

Section: Discussionsupporting

confidence: 60%

Prevalence of Cutaneous Manifestations of Diabetes Mellitus

Verma¹

2013

IOSR-JDMS

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“…9,12) In the epidermis, glycated keratin leads to a yellowish change in skin color and decrease in water content of the SC, resulting in skin dryness. 13) Moreover, glycation of dermal collagen and elastic fibers contributes to stiffness and loss of elasticity, forming wrinkles. 14,15) In addition to the modification of structural proteins, AGEs also induce biological reactions via binding to receptor for AGEs (RAGE).…”

mentioning

confidence: 99%

Permeation of Hydrophilic Molecules across Glycated Skin Is Differentially Regulated by the Stratum Corneum and Epidermis–Dermis

Yokota

Tokudome

2015

Biological & Pharmaceutical Bulletin

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The effects of glycation on skin permeation and accumulation of compounds were evaluated using an in vitro glycated skin model. Glycation of the skin of hairless mice was induced using vertical diffusion cells and incubation with phosphate-buffered saline containing 50 mM glyoxal for 24 h. Flux and accumulation in the skin were determined by applying hydrophilic and lipophilic molecules (Sodium fluorescein; FL-Na and Nile red, respectively) to this in vitro glycated skin model. Furthermore, to investigate the effect of glycation on epidermal-dermal barrier properties, we conducted diffusion experiments with FL-Na and fluorescein isothiocyanate-dextran using stratum corneum (SC)-stripped glycated skin. The in vitro glycated skin model demonstrated characteristic glycation alterations like a yellowish change in skin color and surface roughness. For low-molecular weight (MW) hydrophilic molecules, flux across glycated full-thickness skin was higher than that across normal skin, although there was no difference with lipophilic molecules. However, glycated epidermis-dermis showed lower flux, and the difference increased with the MW of the compound. Furthermore, the amount of high-MW hydrophilic molecules accumulated in glycated epidermis-dermis was decreased. These results suggest that glycated SC and epidermis-dermis differentially regulate the permeability of hydrophilic molecules and highlight the importance of controlling drug delivery by modifying the formulation or method of application depending on skin condition. Key words skin permeation; advanced glycation end product; stratum corneum As a route of drug administration, the skin attracts much attention due to non-invasive application, ease of dose control and absorption without hepatic first-pass metabolism. However, human skin changes over time due to chronological aging, exposure to UV radiation, and diseases such as atopic dermatitis and psoriasis. With the increase in the aging population in recent decades, there is a growing need to care for a variety of skin types. Therapeutic applications involving the skin have also increased in diversity in recent years. A variety of chemical and physiological methods are being studied to lower the barrier posed by the skin's outermost layer, the stratum corneum (SC).1) Consisting of corneocytes and intercellular lipids, the SC plays an important role as a rate limiting layer for the penetration of compounds. Serving as the major protection from foreign chemicals and water loss, and also associated with body temperature regulation, the SC is permeable to only lipophilic and <500 Da compounds.2) Therefore, various biochemical approaches to increase permeability across the SC have been attempted over the years.3) Physical methods such as microneedles, thermal ablation and microdermabrasion are also used to enhance the efficiency of penetration by piercing or removing the SC. Additionally, iontophoresis and sonophoresis increase skin permeability by electrical driving force and ultrasound, respectively. 4)Despite many ...

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Functional properties of the stratum corneum in patients with diabetes mellitus: similarities to senile xerosis

Abstract: These new results as well as our earlier results with diabetic mice suggest that patients with diabetes mellitus tend to show a reduced hydration state of the SC together with decreased sebaceous gland activity, without any impairment of the SC barrier function.

Cited by 118 publications

References 28 publications

The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

The Prevalence of Cutaneous Manifestations in Young Patients With Type 1 Diabetes

Prevalence of Cutaneous Manifestations of Diabetes Mellitus

Permeation of Hydrophilic Molecules across Glycated Skin Is Differentially Regulated by the Stratum Corneum and Epidermis–Dermis

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