Abstract

Objective. The aim of the study was to assess the prevalence of cutaneous disorders and their relation to disease duration, metabolic control, and microvascular complications in children and adolescents with IDDM.

Research design and methods. The presence and frequency of skin manifestations were examined and compared in 212 unselected IDDM patients (aged 2-22 years, diabetes duration 1-15 years) and 196 healthy sex- and age-matched control subjects. Logistic regression was used to analyze the relation of cutaneous disorders with diabetes duration, glycemic control, and microvascular complications.

Results. One hundred forty-two (68%) IDDM patients had at least one cutaneous disorder vs. 52 (26.5%) of controls (P<0.01). Diabetes associated skin lesions were found in 81 (38%) patients. Acquired ichthyosis, rubeosis faciei, diabetic hand and necrobiosis lipoidica were seen in 22 vs. 3%, 7.1 vs 0%, 2.3 vs. 0%, and 2.3 vs. 0% of IDDM and controls, respectively. The frequency of cutaneous reactions to insulin therapy was low -- 2.7%. The prevalence of fungal infections in patients and controls was 4.7% and 1.5%, respectively. Keratosis pilaris affected 12% of our patients vs. 1.5% controls. Diabetic hand was strongly (OR=1.42; P<0.001; 95%CI =1.11-1.81), and rubeosis faciei weakly (OR=1.22; P=0.0087; 95%CI=1.04-1.43) associated with diabetes duration. Significant association was also found between acquired ichthyosis and keratosis pilaris (OR=1.53; P<0.001; 95%CI=1.09-1.79).

Conclusions. Cutaneous manifestations are common in IDDM patients, and some of them, like acquired ichthyosis and keratosis pilaris develop early in the course of the disease. Diabetic hand and rubeosis faciei are related to the disease duration.