Pavlović Milos D, Milenković Tatjana, Dinić Miroslav, Misović Milan, Daković Dragana, Todorović Sladana, Daković Zorana, Zecevi Rados D, Doder Radoje
Department of Dermatology, Military Medical Academy, Crnotravska 17, 11002, Belgrade, Serbia.
Diabetes Care. 2007 Aug;30(8):1964-7. doi: 10.2337/dc07-0267. Epub 2007 May 22.
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.
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.
One hundred forty-two (68%) type 1 diabetic patients had at least one cutaneous disorder vs. 52 (26.5%) control subjects (P < 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 < 0.001), and rubeosis faciei weakly (1.22 [1.04-1.43]; P = 0.0087), associated with diabetes duration. Significant association was also found between acquired ichthyosis and keratosis pilaris (1.53 [1.09-1.79]; P < 0.001).
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.
本研究旨在评估1型糖尿病儿童和青少年皮肤疾病的患病率及其与病程、代谢控制和微血管并发症的关系。
对212例未经挑选的1型糖尿病患者（年龄2 - 22岁，糖尿病病程1 - 15年）和196例年龄及性别匹配的健康对照者进行皮肤表现的检查和比较。采用逻辑回归分析皮肤疾病与糖尿病病程、血糖控制及微血管并发症之间的关系。
142例（68%）1型糖尿病患者至少有一种皮肤疾病，而对照者为52例（26.5%）（P < 0.01）。81例（38%）患者发现有糖尿病相关皮肤病变。1型糖尿病患者和对照者中，获得性鱼鳞病、面部潮红、糖尿病手和类脂质渐进性坏死的发生率分别为22%对3%、7.1%对0%、2.3%对0%和2.3%对0%。胰岛素治疗引起的皮肤反应频率较低（-2.7%）。患者和对照者中真菌感染的患病率分别为4.7%和1.5%。毛发角化病在我们的患者中占12%，对照者中占1.5%。糖尿病手与病程密切相关（比值比1.42 [95%可信区间1.11 - 1.81]；P < 0.001），面部潮红与病程轻度相关（1.22 [1.04 - 1.43]；P = 0.0087）。获得性鱼鳞病和毛发角化病之间也存在显著关联（1.53 [1.09 - 1.79]；P < 0.001）。
皮肤表现在1型糖尿病患者中很常见，其中一些，如获得性鱼鳞病和毛发角化病，在疾病早期就会出现。糖尿病手和面部潮红与病程有关。
