Diabetul zaharat în dermatologie: studiu bazat pe 182 de cazuri clinice

Abstract

Background: Diabetes mellitus (DM) is the most common endocrine disease. It is estimated that by 2025, it will affect 5.4% of the global population. DM does not leave any tissue or organ unaffected; moreover, cutaneous manifestations develop alongside disturbances of internal organs. Cutaneous manifestations in diabetes mellitus (CMDM) are encountered in 20 - 30% of cases. They are often the first symptoms of diabetes, thus having an important role in diagnosing this disease. Out of these cases, skin infections are the most commonly encountered constituting 20% to 50%. Patients with type II diabetes frequently develop skin infections, while those with type I develop autoimmune lesions. Material and methods: The study group comprised 182 patients diagnosed with CMDM, including 103 women and 79 men, aged between 20-81 years who were hospitalized during 2010-2011 at Department of Women’s and Men’s Dermatology of the Republican Dermatovenerologic Dispensary, Chisinau. The patient records were examined according to a survey that included: gender, age, area of residence, type of diabetes, type of skin lesion, morbid associations, glucose, glucosuria, proteinuria, microscopy, bacteriology, histopathology, etc., observing the inclusion and exclusion criteria. The statistical data was analyzed and compared with the one presented in the medical literature. Results: The results demonstrate that patients came mainly from rural areas 114 (62.63%) and urban - 68 (37.36%), 8 patients (1.52 ± 4.40%) had type I diabetes and 174 patients (95.60 ± 1.52%) – type II diabetes. The several of CMDM were present in the age group of 51-65 years with feminine predominance. Skin infections were the most common (66 cases). Out of the total group of patients, 93 (51.1%) had cutaneous pruritus. According to correlative share, it was determined that certain severe skin itching is associated with higher blood glucose levels. Depending on 5 levels of blood glucose level it was determined that the largest share of skin infections - 22 patients (40%) is associated with glucose levels from 7.9 to 11.0 mmol/l. Conclusions: CMDM are often present in women aged 51-65 years, often from rural areas and it is type II diabetes. The most frequent group of CMDM are skin infections. Every second patient complained of cutaneous pruritus. Severe skin itching and skin infections are frequently associated with a high glycemic level. Therapeutic success is directly proportional to decreasing glucose levels and maintaining its normal values, and the fair treatment of cutaneous manifestations of diabetes.