Cutaneous manifestations in children patients with type 1 diabetes mellitus

Abstract

Background and Design: Type 1 diabetes mellitus (T1DM) can cause significant changes in the skin. However, there are limited studies examining the skin findings in children with T1DM. The objective of this study is to determine the frequency of skin lesions in children with T1DM. Additionally, this study also evaluates the relationship of skin lesions with disease duration and hemoglobin A1c (HbA1c) levels. Materials and Methods: This cross-sectional study enrolled 65 children with T1DM and 78 age- and sex-matched healthy children. Importantly, detailed skin examinations of the cases were conducted. Results: The mean age at the onset of disease was 7.1±3.7 years, and the mean duration of T1DM was 45.9±40.4 months. The mean level of HbA1c in children with T1DM was determined as 8.0±1.6%. In total, 9 (13.8%) of the patients were using insulin infusion pump, whereas 56 of them were using multiple insulin injections therapy. At least one skin lesion related to insulin treatment was recorded in 54 patients (83%). Bruises (50.8%), lipohypertrophy (44.6%), and post-inflammatory hyperpigmentation (26.2%) were among the most observed skin reactions related to the insulin treatment. However, hypopigmented scar was the most frequently observed skin reaction related to the insulin treatment among the patients using insulin infusion pump (5/9, 55%). Only xerosis and rubeosis faciei diabeticorum were found to be significantly higher in the T1DM group, as compared to healthy controls. Xerosis was observed in 19 (29%) patients with DM and 8 (10.2%) healthy controls, whereas rubeosis faciei was observed in 6 (9.2%) patients with DM and 1 (1.3%) healthy control. Although not statistically significant, it was found that the disease duration was longer and HbA1c levels were higher in T1DM patients with rubeosis faciei or xerosis. Conclusion: We believe that significant benefits can be provided for the management and prevention of skin findings in children with T1DM through the training of the patients and caregivers as well as by increasing the awareness of physicians.

Keywords

• children
• insulin
• lipodystrophy
• type 1 diabetes mellitus