Published in:
01-07-2019 | Original Article
Clinical, radiological, and histological characteristics of Chinese type 2 diabetic patients with diabetic scleredema: an observational study
Published in: International Journal of Diabetes in Developing Countries | Issue 3/2019
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Objectives
Diabetic scleredema (DS) is reported rarely in China and its features are poorly documented. We aim to describe the characteristics of Chinese patients with DS clinically, radiologically, and histologically.
Methods
Of 9825 hospitalized participants with diabetes older than 18 years, 15 type 2 diabetes patients with DS as well as 15 non-DS patients with type 2 diabetes were included in this observational study.
Results
All the individuals with DS presented diffuse erythema, non-pitting, and painless indurations on the skin of the nape and upper back. Patients with DS were mainly middle-aged or elderly (male to female ratio, 4:1), with long-standing poorly controlled type 2 diabetes, overweight, or obese. Patients with DS vs non-DS had a higher prevalence of diabetic microvascular complications, neuropathy, hypertension, cerebral infarction, nicotine abuse, and alcohol abuse. LDL-C level was significantly higher in the DS group (p = 0.0143), and the skin and subcutaneous fat in T2-weighted MRI were significantly thickened in the DS group than in the non-DS group (p < 0.01). Skin biopsies showed thickened collagen bundles throughout the dermis and active fibroblast proliferation.
Conclusion
Our reports suggest that DS is relatively rare in Chinese patients with diabetes. DS occurs both in middle-aged and elderly patients (male predominantly), overweight or obese, having long-term poorly controlled type 2 diabetes, and presenting a high incidence of microvascular complications, hypertension, neuropathy, and ischemic cerebral stroke. High LDL-C level, nicotine abuse, and alcohol abuse may be risk factors. MRI could be preferable to assess the severity of DS non-invasively.