Kochet K, Lytus I, Svistunov I, Sulaieva O
Shupyk National Medical Academy of Postgraduate Education; Ukrainian Research and Practical Centre of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine.
Georgian Med News. 2017 Dec(273):41-46.
Skin pathology is registered in vast majority of patients with diabetes mellitus (DM). Despite the abundance of publications on dermatological problems in DM, there is still a number of gaps to be discussed in terms of pathophysiological mechanisms. The goal of this review was to assess the mechanisms of development of different skin pathologies under DM. One of the key pathogenic mechanisms of skin lesions in diabetes is hyperglycemia and the effects of the advanced glycation end products, inducing oxidative stress, endothelial dysfunction and inflammation; that in its turn can accelerate the mechanisms of skin aging, the development of diabetic dermopathy and scleredema diabeticorum. Imbalance of growth factors, cytokines and hormones under insulin resistance, is associated with increased proliferation of keratinocytes, fibroblasts and sebocytes, mast cell dysfunction and melanogenesis disorders in acanthosis nigricans, acrochordons, acne and inflammatory dermatitis in diabetic patients. In addition, authors discuss the role of dendritic cells and macrophages dysfunction in impairment of peripheral tolerance and diabetic wounds pathogenesis in patients with DM.
绝大多数糖尿病患者都存在皮肤病变。尽管关于糖尿病皮肤问题的出版物众多,但在病理生理机制方面仍有一些空白有待探讨。本综述的目的是评估糖尿病患者不同皮肤病变的发生机制。糖尿病皮肤病变的关键致病机制之一是高血糖以及晚期糖基化终产物的影响,这些会引发氧化应激、内皮功能障碍和炎症;进而加速皮肤老化、糖尿病性皮肤病和糖尿病性硬皮病的发生机制。胰岛素抵抗状态下生长因子、细胞因子和激素的失衡,与糖尿病患者黑棘皮病、皮赘、痤疮和炎症性皮炎中角质形成细胞、成纤维细胞和皮脂腺细胞增殖增加、肥大细胞功能障碍及黑素生成紊乱有关。此外,作者还讨论了树突状细胞和巨噬细胞功能障碍在糖尿病患者外周耐受性受损和糖尿病伤口发病机制中的作用。