Foss N T, Polon D P, Takada M H, Foss-Freitas M C, Foss M C
Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Rev Saude Publica. 2005 Aug;39(4):677-82. doi: 10.1590/s0034-89102005000400024. Epub 2005 Aug 16.
It is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their relationship with metabolic control of diabetes.
A total of 403 diabetic patients, 31% type 1 and 69% type 2, underwent dermatological examination in an outpatient clinic of a university hospital. The endocrine-metabolic evaluation was carried out by an endocrinologist followed by the dermatological evaluation by a dermatologist. The metabolic control of 136 patients was evaluated using glycated hemoglobin.
High number of dermophytosis (82.6%) followed by different types of skin lesions such as acne and actinic degeneration (66.7%), pyoderma (5%), cutaneous tumors (3%) and necrobiosis lipoidic (1%) were found. Among the most common skin lesions in diabetic patients, confirmed by histopathology, there were seen necrobiosis lipoidic (2 cases, 0.4%), diabetic dermopathy (5 cases, 1.2%) and foot ulcerations (3 cases, 0.7%). Glycated hemoglobin was 7.2% in both type 1 and 2 patients with adequate metabolic control and 11.9% and 12.7% in type 1 and 2 diabetic patients, respectively, with inadequate metabolic controls. A higher prevalence of dermatophytoses was seen in the both groups with inadequate metabolic control.
The results showed a high prevalence of skin lesions in diabetic patients, especially dermatophytoses. Thus, poor metabolic control of diabetes increases patient's susceptibility to skin infections.
糖尿病与糖尿病患者皮肤病变的决定因素或触发因素之间的关系尚不清楚。本研究的目的是调查糖尿病患者中未报告的皮肤病变的存在情况及其与糖尿病代谢控制的关系。
共有403例糖尿病患者在一家大学医院的门诊接受了皮肤科检查,其中1型糖尿病患者占31%,2型糖尿病患者占69%。由内分泌科医生进行内分泌-代谢评估,随后由皮肤科医生进行皮肤科评估。使用糖化血红蛋白对136例患者的代谢控制情况进行评估。
发现大量皮肤癣菌病(82.6%),其次是不同类型的皮肤病变,如痤疮和光化性退变(66.7%)、脓疱病(5%)、皮肤肿瘤(3%)和类脂质渐进性坏死(1%)。在经组织病理学证实的糖尿病患者最常见的皮肤病变中,可见类脂质渐进性坏死(2例,0.4%)、糖尿病性皮肤病(5例,1.2%)和足部溃疡(3例,0.7%)。代谢控制良好的1型和2型患者的糖化血红蛋白分别为7.2%,而代谢控制不佳的1型和2型糖尿病患者的糖化血红蛋白分别为11.9%和12.7%。在代谢控制不佳的两组患者中,皮肤癣菌病的患病率更高。
结果显示糖尿病患者皮肤病变的患病率很高,尤其是皮肤癣菌病。因此,糖尿病代谢控制不佳会增加患者对皮肤感染的易感性。