Haustein U F
Department of Dermatology, University of Leipzig, Germany.
J Eur Acad Dermatol Venereol. 1999 Jul;13(1):50-3.
We report on two patients (one female 42 years, one male 47 years) suffering from insulin-dependent diabetes mellitus (IDDM) for more than 20 years. Both patients exhibited sclerodactyly and sclerosis of the hands and lower arms as well as swelling and slight contracture of the distal interphalangeal joints. Interestingly, internal organs were not involved and autoantibodies characteristic for scleroderma were missing. Poor utilization and excess of glucose seem to be responsible for the activation of fibroblasts to produce abundant matrix proteins in the skin. Significant therapeutic improvement of the glucose metabolism was able to improve joint contractures or at least to stop the progression of skin changes in our patients. These skin changes should not be misdiagnosed as systemic sclerosis.
我们报告了两名患有胰岛素依赖型糖尿病（IDDM）超过20年的患者（一名42岁女性，一名47岁男性）。两名患者均表现出手指硬皮病以及手部和下臂硬化，同时远端指间关节肿胀并伴有轻度挛缩。有趣的是，内脏未受累且缺乏硬皮病特有的自身抗体。葡萄糖利用不佳和过量似乎是成纤维细胞活化以在皮肤中产生大量基质蛋白的原因。葡萄糖代谢的显著治疗改善能够改善关节挛缩，或者至少阻止我们患者皮肤变化的进展。这些皮肤变化不应被误诊为系统性硬化症。
