Study of cutaneous manifestations of type 2 diabetes mellitus
Keywords:Diabetes mellitus, Cutaneous manifestations, Atherosclerosis, Fungal infection
Background: Poorly controlled Type 2 diabetes mellitus (DM) is associated with several disorders and microvascular, macrovascular and neuropathic complications. Multiple factors play a role in the manifestations of cutaneous signs of DM. The prevalence of a cutaneous disorder appears to be similar between Type 1 DM and Type 2 DM patients, but Type 2 DM patients develop more frequent cutaneous infections, and Type 1 DM patients manifest more autoimmune-type cutaneous lesions. The objective of the study was to assess the various cutaneous manifestations of Type 2 DM and the relation of cutaneous manifestations with the duration of Type 2 DM.
Methods: All patients of Type 2 DM, of age group 20 and above, of both sexes, attending OPD or IPD at Dr. D. Y. Patil Hospital, Kolhapur willing to give written informed consent, were included for the study between August 2014 – July 2016. Complete history and examination of all the patients with regards to onset of cutaneous manifestations was taken.
Results: Majority (49%) of respondents were in the age group of 41 to 60 years, and majority (66%) were males. 57.5% were new cases and 42.5% were known cases. Duration of illness- majority 50.58% were <5 years, 27.05% in 6 to 10 years. In present study there were 61% who had infectious skin manifestations and 39% who had non-infectious skin manifestations. Out of infectious manifestations 39.5% had fungal infection.
Conclusions: Therefore on the basis of present study, we conclude that the skin is involved in DM quite often. The manifestations are numerous and varied and many a times they can serve as diagnostic marker for underlying DM. Whenever patients present with multiple skin manifestations, their diabetic status should be checked. The recognition of these skin findings is the key to treatment and prevention.
Sahay BK. Diabetes mellitus-basic considerations. In: Saha SN, editor. API Text of Medicine, 8 th ed. Mumbai: The Association Of Physicians of India.2008:1042-43.
Amany Ali Sayed Abd El Nasser. Cutaneous Manifestations Among Diabetic Children. Egyptian Paediatric Association Gazette. 2012;2:12-15.
Bhat YJ, Gupta V, Kudyar RP. Cutaneous manifestations of diabetes mellitus. Int J Diab Dev Ctries. 2006;26:152-5.
Goyal A, Raina S, Kaushal SS, Mahajan V, Sharma NL. Pattern of cutaneous manifestations in diabetes mellitus. Indian Journal of Dermatology. 2010;55(1):39-41.
Sasmaz S, Buyukbese MA, Cetinkaya A, Celik M, Arican O. The prevalence of skin disorders in type-2 diabetic patients. Int J Dermatol. 2005:3:1.
Nawaf AI-Mutairi. Skin diseases seen in diabetes mellitus. Bull Kuwait Inst Med spec 2006;5:30-9.
Goyal A, Raina S, Kaushal SS, Mahajan V, Sharma NL. Pattern of cutaneous manifestations in diabetes mellitus. Indian J Dermatol. 2010:55(1):39-41.
Ahmed K, Muhammad Z, Qayum I. Prevalence of cutaneous manifestations of diabetes mellitus. J Ayub Med Coll Abbottabad. 2009;21:76-9.
Giligor RS, Lazarus GS. In: Diabetes Mellitus, eds. Rifkin H, Raskin P, Bradyco, Louna. 1981; 313-321.
Greenwood AM. A study of skin in 500 diabetics. JAMA. 1927;89:774-79.
Urbach K, Lentz JW. Carbohydrate metabolism and skin. Arch Dermatol Syphilol. 1965;52:301-4.
Khurshid S, Govada L, EL-Sharif HF, Reddy SM, Chayen NE. Automating the application of smart materials for protein crystallization, Acta Crystallogr D Biol Crystallogr. 2015;71(3):534–40.
Perez MI, Kohn SR. Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol. 1994;30(4):519-31.
Kozjak-Pavlovic V, Ross K, Benlasfer N, Kimmig S, Karlas A, Rudel T. Conserved roles of Sam50 and metaxins in VDAC biogenesis. EMBO Rep. 2007;8(6):576-82.
Galdeano F, Zaccaria S, Parra V, Giannini ME, Salomón S. Cutaneous manifestations of diabetes mellitus: clinical meaning. Dermatol Argent. 2010;16(2):117-21.
Goyal A, Raina S, Kaushal SS, Mahajan V, Sharma NL. Pattern Of Cutaneous Manifestations In Diabetes Mellitus. Indian J Dermatol. 2010;55(1):39–41.
Chatterjee N, Chattopadhyay C, Sengupta N, Das C, Sarma N, Salil K Pa. An observational study of cutaneous manifestations in diabetes mellitus in a tertiary care Hospital of Eastern India. Indian J Endocrinol Metab. 2014;18(2):217–20.
Sanad EM, ElFangary MM, Sorour NE, ElNemisy NM. Skin manifestations in Egyptian diabetic patients: a case series study. Egypt J Dermatol Venerol. 2013;33:56-62.
Timshina DK, Thappa DM, Agrawal A. A clinical study of dermatoses in diabetes to establish its markers. Indian J Dermatol. 2012;57:20-5.
Anuragi Arun Kumar, Shamshad Husain Ansari, Vijay Gupta. A Study on Cutaneous Manifestations in Patients of Type 2 Diabetes Mellitus in a Tertiary Care Hospital. Int J Med Res Prof. 2016;2(1):125-7.
Shahzad M, Al Robaee A, Al Shobaili HA, Alzolibani AA, Al Marshood AA, Al Moteri B. Skin manifestations in diabetic patients attending a diabetic clinic in the Qassim region, Saudi Arabia. Med Princ Pract. 2011;20:137–41.