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

Current data concerning cutaneous allergy to insulin may be illustrated by the two cases reported here. One was a woman with gestational diabetes; she was treated with bovine insulin and developed generalized urticaria which subsided after switching to human insulin. The other was a woman who had pruritus localized to the site of injection with every type of insulin and in whom laboratory examinations showed an increase of specific IgE. Immunological reactions have been described since the time when exogenous insulin was introduced as a treatment of diabetes. The wide use of purified human insulin has considerably reduced their incidence but benign local and immediate systemic reactions are still being reported, their estimated frequency varying from 10 p. 100 to 50 p. 100 of the patients treated. In reality, allergy to insulin itself is extremely rare compared with allergic reactions to preservatives, such as metacresol, additives (protamine and zinc and contaminants present in insulin preparations: desamido-insulin. True allergic reactions to insulin may be localized or generalized and biphasic, and in most cases they are IgE-mediated. Some late local reactions, as well as atrophy, can be ascribed to delayed hypersensitivity. Treatment includes: (i) change in the type of insulin used; (ii) systemic or topical corticosteroid therapy; (iii) antihistamines and aspirin, and (iv) desensitization. The allergic complications of insulin therapy are benign; they usually do not require any particular treatment and often spontaneously regress.
Ann Dermatol Venereol 1988
PMID:[Cutaneous allergic accidents caused by insulin. Current aspects apropos of 2 cases]. 297 69

Twelve female patients with necrobiosis lipoidica diabeticorum (six with diabetes and six without) had a 5-mm punch biopsy of the skin lesion performed. The tissue was processed for dermatopathologic examination in 12 cases and for direct immunofluorescence in 11. Vasculopathy with inflammation and thickening of vessel walls, at times leading to occlusion, was found in lesional skin in all 12 cases. Vessels contained deposits of immunoreactants in the involved skin in 11 cases. This included IgM in six, C3 in nine, fibrin in ten, IgG in one, and IgA in two. Vessels contained deposits of immunoreactants in uninvolved skin in seven patients (C3 in four, IgM in three, fibrin in three, C4 in one, and IgA in one), three of whom had type I diabetes.
Arch Dermatol 1988 Sep
PMID:The cutaneous immunopathology of necrobiosis lipoidica diabeticorum. 304 97

A case of reticular erythematous mucinosis associated with chronic idiopathic thrombocytopenic purpura and circulating immune complexes is described. We compare reticular erythematous mucinosis with the similar plaquelike cutaneous mucinosis. We discuss the apparent photosensitivity of reticular erythematous mucinosis and its possible relationship with altered states of immune function such as diabetes, thyroid disease, and neoplasia. The somewhat varied but characteristic histopathologic findings and staining are reviewed, including the characteristic perivascular and occasional perifollicular lymphocytic infiltrate and Alcian blue-positive dermal mucin. Treatment with antimalarial drugs still appears to be the most uniformly successful therapeutic approach to the management of this chronic dermatosis. Further research efforts should be directed at understanding its link with altered states of immune function.
J Am Acad Dermatol 1988 Nov
PMID:Reticular erythematous mucinosis and thrombocytopenic purpura. Report of a case and review of the world literature, including plaquelike cutaneous mucinosis. 305 96

Vitiligo is a disease that affects from 1 to 3 per cent of the population. It is characterized by cutaneous white macules that often develop in cosmetically important areas such as the face, the dorsal hands, and the arms. It may be accompanied by ocular abnormalities and a number of associated disorders such as thyroid disease, diabetes, pernicious anemia, and alopecia areata. There is increasing evidence that vitiligo is an autoimmune disease. Although there is as yet no definitive cure, many patients have obtained respectable repigmentation by the use of topical or oral psoralen plus ultraviolet light. When large areas of skin are involved or when the patient is unresponsive to therapy, serious consideration should be given to depigmentation with monobenzone (Benoquin).
Dermatol Clin 1988 Jul
PMID:Vitiligo. 316 34

A review of 76 patients with lichen sclerosus et atrophicus reveals a number of cases in which this disorder is associated with glucose intolerance or diabetes mellitus. The performance of an oral glucose tolerance test is therefore recommended for all patients with lichen sclerosus et atrophicus.
J Am Acad Dermatol 1988 Sep
PMID:Lichen sclerosus et atrophicus. A study of 76 cases and their relation to diabetes. 267 23

One hundred sixteen patients with granuloma annulare and necrobiosis lipoidica were studied. The relationship of these two disorders with diabetes mellitus suggests that atypical granuloma annulare could be linked to necrobiosis lipoidica, toward which it progresses.
Int J Dermatol 1988 Oct
PMID:Granuloma annulare, necrobiosis lipoidica, and diabetic disease. 320 19

The varied systemic pathologic alterations that occur in patients with diabetes mellitus may result in profound changes that affect the nail unit. These findings vary from simple onycholysis to a spectrum of infectious processes, as well as extensive, irreversible destruction. The influence of the vascular and neurologic systems in producing these clinical findings is presented. The purpose of this review is to alert the physician to another aspect of diabetes mellitus, namely, its effect on the various components of the nail unit.
J Am Acad Dermatol 1987 May
PMID:Nail changes associated with diabetes mellitus. 329 36

Quinidine-induced lichenoid photodermatitis was definitely isolated by Berger and Sesody in 1982. We had an opportunity to observe 4 cases of this striking clinical condition and encountered some particularities. Our patients (2 men and 2 women) were 60, 64, 81 and 68 years old respectively. All had a previous cardiovascular history; diabetes was also present in patient No. 2, and hypertension in patient No. 4. All patients were taking other drugs. The first patient presented with a 4-year old lichenoid eruption on the hands, associated with some degree of follicular keratosis. The second and third patients had a mixture of mainly lichenoid lesions on sun-exposed areas, but eczematous and desquamative lesions were also encountered. The fourth patient had typical lichenoid photodermatitis with occasional bullae on the arms and legs. In all patients the disease appeared or worsened in the Summer. It disappeared rapidly in 3 cases upon withdrawal of quinidine (patients No. 1 and 2) or hydroquinidine (patient No. 3), but it lasted longer in patient No. 4, with pigmented sequelae. Histological examination of the skin was consistent with a lichenoid eruption in all cases. However, an immunopathological study revealed a pemphigoid-like pattern in patients No. 1 and 2, and ovoid bodies more suggestive of lichen planus in patient No. 4. Photobiology was not performed. A review of the literature showed that the terms "lichen planus", "lichenoid", "lichenification" or "violaceus hue" were frequently encountered, and we suggest quinidine as one of the most common agents of lichenoid reaction.(ABSTRACT TRUNCATED AT 250 WORDS)
Ann Dermatol Venereol 1987
PMID:[Quinidine-induced lichenoid photodermatitis]. 332 45

Endocrinologic disorders occasionally manifest themselves by their associated or induced cutaneous abnormalities. In some instances the initial and most prominent complaints of the patient are related to alterations in the skin, and thus the dermatologist will at times be the first physician consulted. In this article we describe the cutaneous lesions that occur in patients with acromegaly, hypopituitarism, hypothyroidism, hyperthyroidism, diabetes mellitus, glucagonomas, hypercalcemia, hypoparathyroidism, and fibrous dysplasia. In addition, we also discuss the role of the skin in vitamin D metabolism. Whenever possible and where known, we have attempted to point out the pathophysiologic mechanisms that account for the cutaneous changes.
J Am Acad Dermatol 1987 Dec
PMID:Endocrine-skin interactions. Cutaneous manifestations of pituitary disease, thyroid disease, calcium disorders, and diabetes. 332 73

Necrobiosis lipoidica diabeticorum is an unusual dermatologic condition with a characteristic clinical appearance and a clear association with diabetes mellitus. There is currently no treatment that reverses the atrophic changes associated with this lesion. We have carried out a clinicopathologic study on 15 subjects and, in addition, have reviewed 10 further biopsy specimens of necrobiosis lipoidica diabeticorum. We found a frequent association of necrobiosis lipoidica diabeticorum with other chronic complications of diabetes mellitus, including limited joint mobility. It is possible that nonenzymatic glucosylation or other changes in collagen may be important in the etiology of necrobiosis lipoidica diabeticorum and the limited joint mobility. We confirmed that cutaneous anesthesia is usually present in the necrobiosis lipoidica diabeticorum lesions. With the use of an antibody to S100 protein and an immunohistochemical method, there was an apparent decreased number of nerves in the skin lesions. We suggest that sensory loss results from local destruction of cutaneous nerves by the inflammatory process. Finally, in six elliptical biopsies extending into clinically normal skin, we demonstrated that the inflammatory infiltrate of necrobiosis lipoidica diabeticorum extended from the lesion into apparently normal skin surrounding clinically active lesions. Thus, intradermal steroids might be administered to perilesional areas surrounding active lesions in the hope of halting progression.
J Am Acad Dermatol 1988 Mar
PMID:Necrobiosis lipoidica diabeticorum: a clinicopathologic study. 335 Oct 15


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