Cutaneous Manifestations and Nail Changes in Diabetes Mellitus / 대한피부과학회지

ABSTRACT

BACKGROUND: At least 30 per cent of diabetics, which is said to comprise over 3% of general population in Korea, have one or more cutaneous complications during the course of the disease. These skin changes may be the consequences of microangiopathy, arteriosclerosis, direct metabolic disturbances and/or the sequelae of chronic therapy. OBJECTIVE: We tried to observe certain cutaneous and nail changes in diabetics and to relate them with systemic complications, blood sugar level and duration of diabetes. METHODS: During the period of 12 months from March, 1992 to February, 1993, a total of 1858 outpatients diagnosed as diabetes mellitus at Eulji General Hospital were examined. RESULTS: The cutaneous manifestations are observed in 79.5% of diabetics examined and cutaneous infections are the most prevalent(52.3%). Pruritus(p<0.01), anogenital pruritus(p<0.01), peripheral dedema(p<0.05) are more common in females and infections, shin spots, finger pebbles(p<0.01) are more common in males. Systemic complications are observed in 50.7% and the cutaneous manifestations are observed more frequently in patients with systemic complications(p<0.05). Shin spots, diabetic foot, peripneral edema diabetic bullosis are observed frequently associated with systemic microangiopathic complications such as retinopathy, nephropathy and neuropathy(p<0.01). There is a significant correlation between blood sugar level and fungal infections and anogenital pruritus(p<0.01). The frequencies of shin spots, diabetic foot and diabetic bullosis increase with the length of time diabetes has been present. Nail changes are observed in 39.6% of diabetics and onychomycosis is the most frequent(34.5%). CONCLUSION: It is suggested that cutaneous shgns especially fungal infections in diabetics are on the increase in Korea. A variety of skin conditions are encountered with diabetes mellitus and the dermatologist may be able to make a significant contribution in the control of diabetes mellitus by identifying skin signs and conditions as diabetic complications.