[en] BACKGROUND: Some relationships are established between diabetes mellitus (DM) and a series of cutaneous disorders. Specific dermatoses are markers for undiagnosed DM. Other disorders represent supervening complications in an already treated DM patient. OBJECTIVE: To review the information about dermocosmetic care products and their appropriate use in the management and prevention of dermatoses related to DM. METHOD: The peer-reviewed literature and empiric findings are covered. Owing to the limited clinical evidence available for the use of dermocosmetics, a review of the routine practices and common therapies in DM-related dermatoses was conducted. RESULTS: Some DM-related dermatoses (acanthosis nigricans, pigmented purpuric dermatosis) are markers of macrovascular complications. The same disorders and some others (xerosis, Dupuytren's disease) have been found to be more frequently associated with microangiopathy. Other skin diseases (alopecia areata, vitiligo) were found to be markers of autoimmunity, particularly in type 1 DM. Unsurprisingly, using dermocosmetics and appropriate skin care has shown objective improvements of some DM-related dermatoses, such effects improve the quality of life. The most common skin manifestations of DM fall along continuum between "dry skin," xerosis, and acquired ichthyosis, occurring predominately on the shins and feet. Dermocosmetic products improve the feeling of well-being for DM patients.
Disciplines :
Dermatology
Author, co-author :
PIERARD, Gérald ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Seite, Sophie
Hermanns-Lê, Trinh ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Delvenne, Philippe ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Anatomie et cytologie pathologiques
Scheen, André ; Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques
Franchimont, Claudine ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Département des sciences biomédicales et précliniques
Language :
English
Title :
The skin landscape in diabetes mellitus. Focus on dermocosmetic management.
Publication date :
2013
Journal title :
Clinical, Cosmetic and Investigational Dermatology
Jelinek JE. The skin in diabetes. Diabetic Med. 1993;10(3):201-213.
Perez MI, Kohn SR. Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol. 1994;30(4):519-531.
Piérard-Franchimont C, Piérard GE, Lefèbvre P. Cutaneous manifestations of diabetes. Rev Med Liège. 1996;51(5):348-354. French.
Romano G, Moretti G, Di Benedetto A, et al. Skin lesions in diabetes mellitus: prevalence and clinical correlations. Diabetes Res Clin Pract. 1998;39(2):101-106.
Yosipovitch G, Hodak E, Vardi P, et al. The prevalence of cutaneous manifestations in IDDM patients and their association with diabetes risk factors and microvascular complications. Diabetes Care. 1998;21(4):506-509.
Flagothier C, Quatresooz P, Bourguignon R, Piérard-Franchimont C, Piérard GE. Cutaneous stigmata of diabetes mellitus. Rev Med Liège. 2005;60(5-6):553-559. French.
Kalus AA, Chien AJ, Olerud JE. Diabetes mellitus and other endocrine diseases. In: Goldsmith L, Katz S, Gilchrest B, Paller A, Leffell D, Wolff K, editors. Fitzpatrick's Dermatology in General Medicine, 8th ed. New York, NY: McGraw-Hill; 2012:151.
Diris N, Colomb M, Leymarie F, Durlach V, Caron J, Bernard P. Non infectious skin conditions associated with diabetes mellitus: a prospective study of 308 cases. Ann Dermatol Venereol. 2003; 130(11):1009-1014. French.
Nazratun N, Mahmood AA, Kuppusamy UR, Ahmad TS, Tan SY. Diabetes mellitus exacerbates advanced glycation end product accumulation in the veins of end-stage renal failure patients. Vasc Med. 2006;11(4):245-250.
Jack M, Wright D. Role of advanced glycation end products and glyoxalase I in diabetic peripheral sensory neuropathy. Transl Res. 2012;159(5):355-365.
Kang P, Tian C, Jia C. Association of RAGE gene polymorphisms with type 2 diabetes mellitus, diabetic retinopathy and diabetic nephropathy. Gene. 2012;500(1):1-9.
Noordzij MJ, Mulder DJ, Oomen PH, et al. Skin autofuorescence and risk of micro- and macrovascular complications in patients with Type 2 diabetes mellitus-a multi-centre study. Diabet Med. 2012;29(12): 1556-1561.
Perkins BA, Rabbani N, Weston A, et al. Serum levels of advanced glycation endproducts and other markers of protein damage in early diabetic nephropathy in type 1 diabetes. PLoS One. 2012;7(4):e35655.
Ramasamy R, Schmidt AM. Receptor for advanced glycation end products (RAGE) and implications for the pathophysiology of heart failure. Curr Heart Fail Rep. 2012;9(2):107-116.
Quatresooz P, Piérard GE. Immunohistochemical clues at aging of the skin microvascular unit. J Cutan Pathol. 2009;36(1):39-43.
Rendell M, Bamisedun O. Diabetic cutaneous microangiopathy. Am J Med. 1992;93(6):611-618.
Kolbe M, Kaufman JL, Friedman J, Dinerstein C, Mackenzie J W, Boyd CD. Changes in steady-state levels of mRNAs coding for type IV collagen, laminin and fbronectin following capillary basement membrane thickening in human adult onset diabetes. Connect Tissue Res. 1990;25(1):77-85.
Pelizzo M, Zattra E, Nicolosi P, Peserico A, Garoli D, Alaibac M. In vitro evaluation of sunscreens: an update for the clinicians. ISRN Dermatol. 2012;2012:352135.
L'Alloret F, Candau D, Seité S, et al. New combination of ultraviolet absorbers in an oily emollient increases sunscreen effcacy and photostability. Dermatol Ther. 2012;2(1):4.
Uccioli L, Monticone G, Russo F, et al. Autonomic neuropathy and transcutaneous oxymetry in diabetic lower extremities. Diabetologia. 1994;37(10):1051-1055.
Gerrits EG, Lutgers HL, Kleefstra N, et al. Skin autofuorescence: a tool to identify type 2 diabetic patients at risk for developing microvascular complications. Diabetes Care. 2008;31(3):517-521.
Sell DR, Nelson JF, Monnier VM. Effect of chronic aminoguanidine treatment on age-related glycation, glycoxidation, and collagen cross-linking in the Fischer 344 rat. J Gerontol A Biol Sci Med Sci. 2001;56(9): B405-B411.
Pageon H, Técher M P, Asselineau D. Reconstructed skin modifed by glycation of the dermal equivalent as a model for skin aging and its potential use to evaluate anti-glycation molecules. Exp Gerontol. 2008;43(6):584-588.
Draelos ZD, Yatskayer M, Raab S, Oresajo C. An evaluation of the effect of a topical product containing C-xyloside and blueberry extract on the appearance of type II diabetic skin. J Cosmet Dermatol. 2009;8(2): 147-151.
Shemer A, Bergman R, Linn S, Kantor Y, Friedman-Birnbaum R. Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol. 1998;37(2):113-115.
Piérard GE, Arrese Estrada J, Piérard-Franchimont C, Deleixhe-Mauhin F. Is there a link between dendrocytes, fbrosis and sclerosis? Dermatologica. 1990;181(4):264-265.
Davison JE, Davies A, Moss C, Kirk JM, Taibjee SM, Agwu JC. Links between granuloma annulare, necrobiosis lipoidica diabeticorum and childhood diabetes: a matter of time? Pediatr Dermatol. 2010;27(2): 178-181.
Yosipovitch G, Loh KC, Hock OB. Medical pearl: Scleroderma-like skin changes in patients with diabetes mellitus. J Am Acad Dermatol. 2003;49(1):109-111.
Nikkels-Tassoudji N, Henry F, Letawe C, Piérard-Franchimont C, Lefebvre P, Piérard GE. Mechanical properties of the diabetic waxy skin. Dermatology. 1996;192(1):19-22.
Piérard-Franchmont C, Nikkels-Tassoudji N, Lefèbvre P, Piérard GE. Subclinical skin stiffening in adults suffering from type 1 diabetes mellitus. A comparison with Raynaud's syndrome. J Med Eng Technol. 1998;22(5):206-210.
Otto-Buczkowska E, Jarosz-Chobot P. Limited joint mobility syndrome in patients with diabetes. Int J Clin Pract. 2012;66(4):332-333.
Martin C, Requena L, Manrique K, Manzarbeltia FD, Rovira A. Scleredema diabeticorum in a patient with type 2 diabetes mellitus. Case Report Endocrinol. 2011;2011:560273.
Kroft EB, de Jong EM. Scleredema diabeticorum case series: successful treatment with UV-A1. Arch Dermatol. 2008;144(7):947-948.
Barde C, Masouyé I, Saurat JH, Le Gal FA. Scleroedema adultorum Buschke in a diabetic subject: intravenous immunoglobulin therapy. Ann Dermatol Venereol. 2009;136(4):360-363. French.
Lee FY, Chiu HY, Chiu HC. Treatment of acquired reactive perforating collagenosis with allopurinol incidentally improves scleredema diabeticorum. J Am Acad Dermatol. 2011;65(4):e115-e117.
Sehgal VN, Srivastava G, Aggarwal AK, Gupta M, Bhattacharya SN, Verma P. Noninsulin-dependent, type II diabetes mellitus-related dermatoses: part II. Skinmed. 2011;9(5):302-308.
El-Makki Ahmed M, Tamimi AO, Mahadi SI, Widatalla AH, Shawer MA. Hallux ulceration in diabetic patients. J Foot Ankle Surg. 2010;49(1):2-7.
Uhoda E, Debatisse B, Paquet P, Piérard-Franchimont C, Piérard GE. The so-called dry skin of the diabetic patient. Rev Med Liège. 2005; 60(5-6):560-563. French.
Piérard GE. What do you mean by dry skin? Dermatologica. 1989; 179(1):1-2.
Piérard GE, Goffin V, Hermanns-Lê T, Piérard-Franchimont C. Corneocyte desquamation. Int J Mol Med. 2000;6(2):217-221.
Sakai S, Kikuchi K, Satoh J, Tagami H, Inoue S. Functional properties of the stratum corneum in patients with diabetes mellitus: similarities to senile xerosis. Br J Dermatol. 2005;153(2):319-323.
Park HY, Kim JH, Jung M, et al. A long-standing hyperglycaemic condition impairs skin barrier by accelerating skin ageing process. Exp Dermatol. 2011;20(12):969-974.
Serup J. EEMCO guidance for the assessment of dry skin (xerosis) and ichthyosis: clinical scoring systems. Skin Res Technol. 1995;1(3): 109-114.
Piérard-Franchimont C, Petit L, Piérard GE. Skin surface patterns of xerotic legs: the fexural and accretive types. Int J Cosmet Sci. 2001; 23(2):121-126.
Piérard-Franchimong C, Quatresooz P, Piérard GE. Specular light refectance of fakes in seborrhoeic dermatitis of the scalp: a pilot study. Clin Exp Dermatol. 2011;36(7):793-796.
Seiraf H, Farsinejad K, Firooz A, et al. Biophysical characteristics of skin in diabetes: a controlled study. J Eur Acad Dermatol Venereol. 2009;23(2):146-149.
Piérard-Franchimont C, Piérard GE. Beyond a glimpse at seasonal dry skin: a review. Exog Dermatol. 2002;1(1):3-6.
Mac-Mary S, Sainthillier JM, Humbert P. Dry skin and the environment. Exog Dermatol. 2004;3(1):72-80.
Piérard GE, Piérard-Franchimont C, Scheen A. Critical assessment of diabetic xerosis. Expert Opin Med Diag. 2013;7(2):201-207.
Pirot F, Morel B, Peyrot G, et al. Effects of osmosis on water-holding capacity of stratum corneum and skin hydration. Exog Dermatol. 2003;2(1):252-257.
Berardesca E; European Expert Group for Effcacy Measurements on Cosmetics and Other Topical Products (EEMCO). EEMCO guidance for the assessment of stratum corneum hydration: electric methods. Skin Res Technol. 1997;3(2):126-132.
Fischer T W, Wigger-Alberti W, Elsner P. Assessment of "dry skin": current bioengineering methods and test designs. Skin Pharmacol Appl Skin Physiol. 2001;14(4):183-195.
Lee CM, Maibach HI. Bioengineering analysis of water hydration: an overview. Exog Dermatol. 2002;1(1):269-275.
O'goshi K, Serup J. Inter-instrumental variation of skin capacitance measured with the Corneometer. Skin Res Technol. 2005;11(2):107-109.
Lévêque JL, Xhaufaire-Uhoda E, Piéard GE. Skin capacitance imaging, a new technique for investigating skin surface properties. Eur J Dermatol. 2006;16(5):500-506.
Xhaufaire-Uhoda E, Piérard GE, Quatresooz P. The skin landscape following nonoptical capacitance imaging. Am J Clin Dermatol. 2010;11(2):89-94.
Piérard-Franchimont C, Piérard GE. Skin surface stripping in diagnosing and monitoring infammatory, xerotic, and neoplastic diseases. Pediatr Dermatol. 1985;2(3):180-184.
Piérard-Franchimont C, Piérard GE. Assessment of aging and actinic damages by cyanoacrylate skin surface strippings. Am J Dermatopathol. 1987;9(6):500-509.
Piérard GE, Piérard-Franchimont C, Saint-Léger D, Kligman AM. Squamometry: the assessment of xerosis by colorimetry of D-squame adhesive discs. J Soc Cosmet Chem. 1992;47:297-305.
Piérard GE. EEMCO guidance for the assessment of dry skin (xerosis) and ichthyosis: evaluation by stratum corneum strippings. Skin Res Technol. 1996;2(1):3-11.
Piérard-Franchimont C, Henry F, Piérard GE. The SACD method and the XLRS squamometry tests revisited. Int J Cosmet Sci. 2000;22(6): 437-446.
Yoon HS, Baik SH, Oh CH. Quantitative measurement of desquamation and skin elasticity in diabetic patients. Skin Res Technol. 2002;8(4): 250-254.
Schatz H, Altmeyer PJ, Kligman A. Dry skin and scaling evaluated by D-squames and image analysis. In: Serup J, Jemec GBE, Grove GL, editors. Handbook of Non-Invasive Methods and the Skin, 2nd ed. Boca Raton, FA: CRC Press; 2006:375-379.
Takahashi M, Black D, Hughes B, Marks R. Exploration of a quantitative dansyl chloride technique for measurement of the rate of desquamation. Clin Exp Dermatol. 1987;12(4):246-249.
Piérard GE. Microscopic evaluation of dansyl chloride test. Dermatology. 1992;185(1):37-40.
Paye M, Simion FA, Piérard GE. Dansyl chloride labelling of stratum corneum: its rapid extraction from skin predict skin irritation due to surfactants and cleansing products. Contact Dermatitis. 1994;30(2): 91-96.
Piérard GE, Piérard-Franchimont C. Dihydroxyacetone test as a substitute for the dansyl chloride test. Dermatology. 1993;186(2): 133-137.
Uhoda E, Piérard-Franchimont C, Debatisse B, Wang X, Piérard GE. Repair kinetics of stratum corneum under repeated insults. Exog Dermatol. 2004;3(1):7-11.
Pavicic T, Korting HC. Xerosis and callus formation as a key to the diabetic foot syndrome: dermatologic view of the problem and its management. J Dtsch Dermatol Ges. 2006;4(11):935-941.
Pham HT, Exelbert L, Segal-Owens A, Veves A. A prospective, randomized, controlled double-blind study of a moisturizer for xerosis of the feet in patients with diabetes. Ostomy Wound Manage. 2002;48(5): 30-36.
Lodén M. Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders. Am J Clin Dermatol. 2003;4(11):771-788.
Lodén M. The clinical beneft of moisturizers. J Eur Acad Dermatol Venereol. 2005;19(6):672-688.
Xhaufaire-Uhoda E, Fontaine K, Piérard GE. Kinetics of moisturizing and frming effects of cosmetic formulations. Int J Cosmet Sci. 2008;30(2):131-138.
Ananthapadmanabhan K P, Yang L, Vincent C, et al. A novel technology in mild and moisturizing cleansing liquids. Cosmet Dermatol. 2009; 22(6):307-316.
Quatresooz P, Piérard-Franchimont C, Szepetiuk G, Devillers C, Piérard GE. Fungal chitin-glucan scaffold for managing diabetic xerosis of the feet in menopausal women. Expert Opin Pharmacother. 2009;10(14):2221-2229.
Shi V Y, Tran K, Lio PA. A comparison of physicochemical properties of a selection of modern moisturizers: hydrophilic index and pH. J Drugs Dermatol. 2012;11(5):633-636.
Seité S, Khemis A, Rougier A, Ortonne J P. Importance of treatment of skin xerosis in diabetes. J Eur Acad Dermatol Venereol. 2011;25(5): 607-609.
Hermanns-Lê T, Scheen A, Piérard GE. Acanthosis nigricans associated with insulin resistance; pathophysiology and management. Am J Clin Dermatol. 2004;5(3):199-203.
Romo A, Benavides S. Treatment options in insulin resistance obesity-related acanthosis nigricans. Ann Pharmacother. 2008;42(7): 1090-1094.
Piérard-Franchimont C, Jebali A, Ezzine N, Letawe C, Piérard GE. Seasonal variations in polymorphis nail surface changes associated with diabetes mellitus. J Eur Acad Dermatol Venereol. 1996;7(2):182-196.
Piérard GE, Piérard-Franchimont C. The nail under fungal siege in patients with type II diabetes mellitus. Mycoses. 2005;48(5):339-342.
Piérard GE, Piérard-Franchimont C, Marks R, Elsner P; EEMCO Group (European Expert Group on Effcacy Measurement of Cosmetics and Other Topical Products). EEMCO guidance for the assessment of hair shedding and alopecia. Skin Pharmacol Physiol. 2004;17(2):98-110.
Goodman JI. Diabetic anhidrosis. Am J Med. 1966;41(5):831-835.
Kennedy WR, Sakuta M, Sutherland D, Goetz FC. Quantifcation of the sweating defcit in diabetes mellitus. Ann Neurol. 1984;15(5): 482-488.
Fealey RD, Low PA, Thomas JE. Thermoregulatory sweating abnormalities in diabetes mellitus. Mayo Clinic Proc. 1989;64(6):617-628.
Piérard GE, Elsner P, Marks R, Masson P, Paye M; EEMCO group. EEMCO guidance for the effcacy assessment of antiperspirants and deodorants. Skin Pharmacol Appl Skin Physiol. 2003;16(5): 324-342.
Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26(5):1553-1579.
Petrofsky JS, Lee S, Patterson C, Cole M, Stewart B. Sweat production during global heating and during isometric exercise in people with diabetes. Med Sci Monit. 2005;11(11):CR515-CR521.
Philips JC, Marchand M, Scheen AJ. Pulse pressure and cardiovascular autonomic neuropathy according to duration of type 1 diabetes. Diabetes Metab Res Rev. 2009;25(5):442-451.
Provitera V, Nolano M, Caporaso G, Stancanelli A, Santoro L, Kennedy WR. Evaluation of sudomotor function in diabetes using the dynamic sweat test. Neurology. 2010;74(1):50-56.
Xhaufaire-Uhoda E, Mayeux G, Quatresooz P, Scheen A, Piérard GE. Facing up to the imperceptible perspiration. Modulation infuences by diabetic neuropathy, physical exercise and antiperspirant. Skin Res Technol. 2011;17(4):487-493.
Noël F, Piérard-Franchimont C, Piérard GE, Quatresooz P. Sweaty skin, background and assessments. Int J Dermatol. 2012;51(6):647-655.
Caucanas M, Piérard-Franchimont C, Piérard GE. Pruritus, a frequent worry. Rev Med Liège. 2010;65(10):593-597. French.
Rurangirwa A, Piérard-Franchimont C, Piérard GE. Growth of Candida albicans on the stratum corneum of diabetic and non-diabetic patients. Mycoses. 1990;33(5):253-255.
Quatresooz P, Paquet P, Hermanns-Lê T, Piérard GE. Molecular mapping of Factor XIIIa-enriched dendrocytes in the skin (Review). Int J Mol Med. 2008;22(4):403-409.
Kumar K V, Priya S, Shaikh A, Prusty P. Diabetes in young - unusual case presentation. J Pediatr Endocrinol Metab. 2011;24(7-8):581-583.
Nakatani K, Kurose T, Hyo T, et al. Drug-induced generalized skin eruption in a diabetes mellitus patient receiving a dipeptidyl peptidase-4 inhibitor plus metformin. Diabetes Ther. 2012;3(1):14.
Piérard-Franchimont C, Hermanns-Lê T, Scheen AJ, Piérard GE. Cutaneous complications of insulin therapy. A drug-induced condition on the decline. Rev Med Liège. 2005;60(5-6):564-565. French.
Radermecker R P, Piérard GE, Scheen AJ. Lipodystrophy reactions to insulin: effects of continuous insulin infusion and new insulin analogs. Am J Clin Dermatol. 2007;8(1):21-28.
Lind PM, Zethelius B, Lind L. Circulating levels of phthalate metabolites are associated with prevalent diabetes in the elderly. Diabetes Care. 2012;35(7):1519-1524.
Drab SR. Recognizing the rising impact of diabetes in seniors and implications for its management. Consult Pharm. 2009;24 Suppl B: S5-S10.
