Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska.
Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles, California.
J Am Acad Dermatol. 2011 Sep;65(3):559-563. doi: 10.1016/j.jaad.2010.06.010. Epub 2011 Apr 29.
Diabetic dermopathy is the most common specific cutaneous finding in diabetes.
Using laser Doppler technology, we tested the hypothesis that diabetic dermopathy arises from abnormal local skin blood flow.
We measured cutaneous blood flow in patients with type 1 diabetes without dermopathy and compared values with those in a control group of patients with type 1 diabetes without diabetic dermopathy and in a nondiabetic group. We measured at 3 separate sites on the pretibial area on the legs of each participant, at dermopathy lesions, and at a number of standard sites on the upper and lower extremities.
We studied 25 patients with diabetes and diabetic dermopathy, average age 51 ± 2 years, mean duration of diabetes 28 ± 3 years. In all, 58 patients with type 1 diabetes without diabetic dermopathy served as control patients, average age 41 ± 2 years, mean duration of diabetes 23 ± 2 years. There were 67 nondiabetic control subjects, average age 47 ± 3 years. The patients with diabetic dermopathy showed a marked reduction in skin blood flow at 35°C at normal-appearing skin areas on the pretibial surface of the legs (1.1 ± 0.1 mL/min/100 g) compared with 1.7 ± 0.1 mL/min/100 g (P = .01) in the type 1 diabetic control group and 2.1 ± 0.3 mL/min/100 g (P < .01) in the nondiabetic group. The dermopathy lesions themselves showed markedly higher blood flow: 2.5 ± 0.3 mL/min/100 g.
Our diabetic dermopathy patients were somewhat older than the control type 1 diabetes subjects, but were of comparable age to the nondiabetic subjects.
These results suggest that patients susceptible to diabetic dermopathy have a functional abnormality in blood flow leading to this scarring process.
糖尿病性皮肤病变是糖尿病患者最常见的特异性皮肤表现。
我们采用激光多普勒技术检测了糖尿病性皮肤病变源于局部皮肤血流异常的假说。
我们测量了无糖尿病性皮肤病变的 1 型糖尿病患者的皮肤血流，并与无糖尿病性皮肤病变的 1 型糖尿病对照组患者和非糖尿病组患者的测量值进行了比较。我们在每位参与者小腿的胫骨前区域的 3 个不同部位、病变部位以及上下肢的多个标准部位测量了血流。
我们研究了 25 例患有糖尿病和糖尿病性皮肤病变的患者，平均年龄 51 ± 2 岁，糖尿病平均病程 28 ± 3 年。共有 58 例无糖尿病性皮肤病变的 1 型糖尿病患者作为对照组患者，平均年龄 41 ± 2 岁，糖尿病平均病程 23 ± 2 年。还有 67 例非糖尿病对照组受试者，平均年龄 47 ± 3 岁。与 1 型糖尿病对照组患者的 1.7 ± 0.1 mL/min/100 g（P =.01）和非糖尿病对照组患者的 2.1 ± 0.3 mL/min/100 g（P <.01）相比，腿部胫骨前表面正常外观皮肤区域的糖尿病性皮肤病变患者的皮肤血流在 35°C 时明显减少，为 1.1 ± 0.1 mL/min/100 g。病变本身显示出明显更高的血流：2.5 ± 0.3 mL/min/100 g。
我们的糖尿病性皮肤病变患者比对照组 1 型糖尿病患者稍年长，但与非糖尿病患者的年龄相当。
这些结果表明，易患糖尿病性皮肤病变的患者存在导致这种瘢痕形成过程的血流功能异常。
