Cutaneous manifestations of Diabetes Melltus - A clinical study.

INTRODUCTION : Diabetes mellitus is a metabolic disorder characterized by elevated fasting and postprandial blood glucose levels and disturbances in the carbohydrate and lipid metabolism. Its prevalence is increasing in the present scenario of a stressful life style in the general population. Abnormalities of insulin and elevated blood glucose level lead to metabolic, vascular, neurological and immunological abnormalities. Affected organs include cardiovascular, renal and nervous systems, eyes and the skin. The skin is affected by both the acute metabolic derangements and the chronic degenerative complications of diabetes. Skin, the largest organ of the body is capable of reflecting these changes in a striking manner and some of the cutaneous markers have been labelled as cutaneous manifestations for this metabolic disorder. Several studies have been conducted to assess the Skin-Diabetes relationship. This is one such study not only to know the Skin-Diabetes relationship but also to explore the newer manifestations with advancing knowledge of the disease. AIM OF THE STUDY ; 1. To study the prevalence of various dermatoses in the diabetic population. 2. To study the age, sex prevalence of diabetic patients with various dermatoses. 3. To compare the dermatoses in the Noninsulin dependent diabetes mellitus patients with those of the Insulin dependent diabetes mellitus. 4. To correlate the recent Glycosylated Haemoglobin level to the common infections in diabetes mellitus patients. 5. To correlate the mean duration of diabetes mellitus in years in relation to cutaneous manifestations in diabetics. 6. To study the occurrence of diabetic therapy induced complications. CONCLUSIONS 1.Infections were the commonest clinical associations observed in our studies. 2. Candidiasis , dermatophytosis and primary bacterial infections were commonly observed in NIDDM patients where as pityriasis versicolor, erythrasma and viral infections were common in IDDM patients. 3. Balanoposthitis in men and vulvovaginitis in women were the common clinical types of candidiasis observed. 4. A rare deep Mycosis, Rhinocerebral zygomycosis was encountered in two uncontrolled IDDM patient. 5. Vitiligo, Oral erosive Lichen planus, Acanthosis nigricans, Granuloma annulare were seen exclusively in IDDM group. 6. Psoriasis, Acrochordons, Localized cutaneous amyloidosis were limited only to the NIDDM group. 7. Half of the diabetic patients with Pruritus had coexisting diabetic neuropathy. 8. Kyrle’s disease exclusively accompanied IDDM patients with diabetic nephropathy. 9. Autonomic and sensory neuropathy induced complications were observed equally in NIDDM and IDDM group. 10. Motor neuropathy and its related complications like diabetic foot ulcer were encountered commonly in IDDM group. 11. Insulin induced complications like Keloid, Lipoatrophy were common in IDDM population than in NIDDM group