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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 66-year-old Japanese woman with a rare acquired perforating disorder, usually called adult-type reactive perforating collagenosis, is reported. The patient had poorly controlled diabetes mellitus with retinopathy under oral diabetic medication. She was found to have multiple papules and umbilicated nodules on the trunk and four extremities when she was admitted and examined for the origin of jaundice and severe pruritus of sudden onset. In the biopsy specimen, collagen fibers were observed to be eliminated from the dermis through epidermal tunnel-like perforations. No elastic fibers were eliminated, and serial sectioning of the specimen could not prove follicular perforation. Adenocarcinoma of the biliary duct was found to be the cause of the jaundice with pruritus. Although such cases are usually classified as acquired reactive perforating collagenosis of adult onset, proposed reclassification for acquired perforating disorders is discussed. Another case which also showed perforation and transepithelial elimination of both collagen and elastic fibers as an incidental histologic finding is described. Such elimination seems to be a not uncommon step in the formation of pruriginous eruptions. Therefore, these cases should be differentiated from acquired-type characteristic perforating disorders.
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PMID:Acquired perforating dermatosis: comparison of an acquired perforating dermatosis and perforation as an incidental histologic finding. 222 54

Patients with renal disease or diabetes mellitus often have an acquired perforating disease of the skin develop that is characterized by hyperkeratotic papules with transepidermal elimination of degenerated material, including collagen or elastic fibers. There is disagreement regarding the most appropriate name for this disease. The pathologic process has been identified by various authors as reactive perforating collagenosis, elastosis perforans serpiginosa, perforating folliculitis, or Kyrle's disease. We have seen four patients with renal disease and/or diabetes whose skin biopsy specimens demonstrated combined transepidermal elimination of both collagen and elastic fibers. This finding is not characteristically seen in any of the previously defined perforating diseases. Since the histologic findings vary greatly in different lesions from different patients with renal disease, we recommend referring to this process as "acquired perforating dermatosis." It is best not to create a new category of perforating disease or to say that a given patient has one of the other four diseases based on random sampling of only a few lesions.
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PMID:Acquired perforating dermatosis. Evidence for combined transepidermal elimination of both collagen and elastic fibers. 1282 63

A 77-year-old patient with diabetes and progressive renal failure suffered from severe pruritus accompanied by umbilicated, keratotic papules corresponding clinically and histologically to reactive perforating collagenosis. UV-B light therapy considerably improved the pruritus and the skin lesions.
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PMID:[Acquired reactive collagen disease in the adult: successful treatment with UV-B light]. 275 60

A multitude of general disorders of the vascular system may also affect the blood circulation of the cochlea and cause symptoms such as fluctuating or permanent hearing loss. Such is the case for arteriosclerosis combined with hypertension or hypotension, collagenosis, and diabetes. Blood disorders, like leukemia, sickle cell anemia, and polycythemia, and infectious diseases involving the blood vessels, such as lues, may also present their primary symptoms in the ear. The otorhinolaryngologist must be able to establish the correct diagnosis and refer patients requiring more general treatment to other specialists. The use of specific vasoactive treatment should be continued to those patients with symptoms of acute or fluctuating hearing loss, vertigo, or tinnitus who exhibit no other signs. Modern techniques for cochlear blood flow measurements have verified that several of the treatment protocols in use, which have a sound theoretical background, do indeed increase cochlear blood flow.
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PMID:Clinical treatment of vascular inner ear diseases. 306 94

Reactive perforating collagenosis is an uncommon skin disorder characterized by extrusion of collagen fibers through the epidermis. The lesions may appear in infancy, from genetic inheritance, or in adulthood in association with diabetes mellitus and/or chronic renal insufficiency. One case of reactive perforating collagenosis is reported, in a 42 year old man, with chronic renal failure diabetes mellitus and undergoing hemodialysis. The literature was reviewed on perforating dermatoses in adults associated with diabetes and chronic renal insufficiency.
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PMID:[Reactive perforating collagenosis associated with chronic renal insufficiency and diabetes mellitus]. 307 Jan 98

Two patients with Hodgkin's disease developed a condition that has been termed "reactive perforating collagenosis." In both cases, pruritus was severe and seemed to be responsible for the vigorous rubbing and scratching that caused the skin lesions. In one patient, the lesions disappeared upon remission of Hodgkin's disease. Perforating collagenosis has been described in children as a hereditary disease, and has also been described in adults with diabetes and on hemodialysis. On the basis of the changes seen in our two patients with Hodgkin's disease, we suggest that perforating collagenosis is simply a consequence of intense scratching.
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PMID:Reactive perforating collagenosis in Hodgkin's disease. 356 11

A case is described with multiple gangrene of the fingers of a female, aged 55, with confirmed cirrhosis of liver and diabetes mellitus. Cryoglobulins were established in the serum. A disturbed immunological balance was present and the family loading with collagenosis raises the problem of genetic moments of the disturbed homeostasis. The existing diabetic microangiopathy, histologically confirmed by biopsy of skin and subcutaneous tissue, brings forward the question of the complex pathogenesis of gangrene. At the end of her stay in the clinic, the patient developed cerebral apoplexy.
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PMID:[Multiple gangrene of the digits in a female patient with liver cirrhosis, diabetes mellitus and cryoglobulinemia]. 403 94

We believe that the disease we are reporting is associated with diabetes, particularly in patients on renal dialysis, and the perforation is initiated by scratching. Decreasing pruritus is the only needed treatment as the lesions tend to resolve on their own. While this entity has been called Kyrle's disease, it more correctly is reactive perforating collagenosis, both clinically and histologically. Whether this is a variant of what Kyrle originally described is not clear. We propose that this entity be called reactive perforating collagenosis of diabetes and renal failure.
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PMID:Reactive perforating collagenosis of diabetes mellitus and renal failure. 682 59

We have noticed in eight male patients transepithelial keratotic plugs which appeared preferentially on zones of supporting points. These plugs evoked in a more or less accurate way, Kyrle's disease or other related syndromes, particularly reactive perforating collagenosis and perforating folliculitis. Seven cases were associated with chronic and severe renal failure complicating a serious diabetes in four cases, one of them with a viral hepatitis. One case has been observed during an important denutrition with digestive disorders.
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PMID:[Hyperkeratosis of the keratotic plug type in patients with chronic renal failure and metabolic diseases]. 713 95

Many methods are available today for clinical evaluation of the blood supply to an extremity or part of an extremity, some of which are excellent for determining the presence and severity of arterial and venous disorders. These methods, however, do not give any information on the microvascular status of the diseased areas. This is particularly true for the skin circulation, which has a rather complex vascular network with nutritional and thermoregulatory vessels, arteriovenous shunts, etc. The most useful method for clinical evaluation of the skin capillary circulation is vital capillary microscopy. The skin capillaries in an area with a reduced microcirculation change in structure, and it is possible to evaluate the viability of the skin by microscopic studies of these capillary changes. Both morphology and blood flow can be investigated. By using different intravital fluorescent dyes, e.g. sodium fluorescein and indocyanine green, the microvascular dynamics, flow distribution and microvascular permeability can also be studied. The total skin microcirculation can be evaluated by Laser Doppler fluxmetry, which measures primarily the blood flow in the thermoregulatory vascular bed, i.e. the subpapillary arterial and venous plexa. It is easy to use in clinical practice, but interpretation of the results can sometimes be difficult. Measuring transcutaneous oxygen tension has for many years been used in clinical routine to evaluate the viability of skin in patients with vascular disorders. It has recently been shown that inhalation of oxygen may induce vasoconstriction in healthy subjects and in patients with moderate arterial insufficiency, but an increase of the skin microcirculation in areas of severe ischaemia. By using different combinations of the above mentioned microcirculatory techniques, valuable information can be gained regarding pathophysiological phenomena of the microcirculation in many diseases, e.g. vascular disorders, collagenosis. Raynaud's phenomenon, diabetes and hypertension. Using techniques for both macro- and microcirculation is also of great importance for evaluating the effect of therapeutic procedures in several of these disorders.
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PMID:Advances in microcirculation network evaluation: an update. 874 87


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