Clinical and Laboratory Investigations
The Prevalence of Diagnosed Cutaneous Manifestations during Ambulatory Diabetes Visits in the United States, 1998–2002Wang Y.R.a, b · Margolis D.b, c, d
aPublic Policy Department, Astra Zeneca Pharmaceuticals, Wilmington, Del., bLeonard Davis Institute of Health Economics, cDepartment of Dermatology, School of Medicine, and dDepartment of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, Pa., USA
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Background: The prevalence of diabetes has been rapidly increasing. Previous reports indicated that diabetics are prone to certain cutaneous diseases. Objective: To determine the frequencies of diagnosed skin conditions during ambulatory diabetes visits in the USA. Methods: We evaluated two national ambulatory medical care surveys between 1998 and 2002 and compared the diagnoses of 7 categories of skin conditions in diabetics (n = 9,626) to patients with hypertension (n = 15,997) or gastroesophageal reflux disease (GERD; n = 2,362) using χ2 tests and multivariate logistic regressions. Results: Diabetics were prone to chronic skin ulcers (odds ratio = 62.5, 95% confidence interval = 3.95–989 compared to GERD; 9.97, 6.34–15.7 compared to hypertension), bacterial skin infections (5.95, 2.86–12.4 compared to GERD; 5.15, 3.74–7.08 compared to hypertension) and fungal skin infections (2.66, 1.15–6.16 compared to GERD; 1.99, 1.32–3.01 compared to hypertension) but not to other skin conditions. These findings remained true during primary care physician visits. Conclusion: Chronic skin ulcers, bacterial and fungal skin infections are more frequently diagnosed in diabetics. We could not verify that other skin conditions are associated with diabetes, in part due to potential underdiagnosis and underreporting.
© 2006 S. Karger AG, Basel
Centers for Disease Control and Prevention: National diabetes fact sheet 2003. http://www.cdc.gov/diabetes/pubs/factsheet.htm.
Jelinek JE: The Skin in Diabetes. Philadelphia, Lea & Febiger, 1986.
- Feingold KR, Elias PM: Endocrine-skin interactions: cutaneous manifestations of pituitary disease, thyroid disease, calcium disorders, and diabetes. J Am Acad Dermatol 1987;17:921–940.
- Jelinek JE: Cutaneous manifestations of diabetes mellitus. Int J Dermatol 1994;33:605–617.
- Perez MI, Kohn SR: Cutaneous manifestations of diabetes mellitus. J Am Acad Dermatol 1994;30:519–531.
- Yosipovitch G, Hodak E, Vardi P, Shraga I, Karp M, Sprecher E, David M: The prevalence of cutaneous manifestations in IDDM patients and their association with diabetes risk factors and microvascular complications. Diabetes Care 1998;21:506–509.
- Shemer A, Bergman R, Linn S, Kantor Y, Friedman-Birnbaum R: Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol 1998;37:113–115.
- O’Toole EA, Kennedy U, Nolan JJ, Young MM, Rogers S, Barnes L: Necrobiosis lipoidica: only a minority of patients have diabetes mellitus. Br J Dermatol 1999;140:283–286.
- Gupta AK, Humke S: The prevalence and management of onychomycosis in diabetic patients. Eur J Dermatol 2000;10:379–384.
- Romano C, Massai L, Asta F, Signorini AM: Prevalence of dermatophytic skin and nail infections in diabetic patients. Mycoses 2001;44:83–86.
- Jabbour SA: Cutaneous manifestations of endocrine disorders: a guide for dermatologists. Am J Clin Dermatol 2003;4:315–331.
- Feldman SR, Camacho F, Williford PM, Siegel DM, Balkrishnan R, Fleischer AB: Patients spend more time with the physician for excision of a malignant skin lesion than for excision of a benign skin lesion. Dermatol Surg 2004;30:351–354.
- Molino AC, Fleischer AB, Feldman SR: Patient demographics and utilization of health care services for molluscum contagiosum. Pediatr Dermatol 2004;21:628–632.
Mellen LA, Feldman SR, Fleischer AB: Treatment of pityriasis versicolor in the United States. J Dermatol Treat 2004;15:1–4.
Practice Management Information Corporation: International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), ed 5. Los Angeles, Practice Management Information Corporation, 1999, hospital edition, vol 1.
- Margolis DJ, Knauss J, Bilker W: Medical conditions associated with venous leg ulcers. Br J Dermatol 2004;150:267–273.
- Scheinfeld NS: Obesity and dermatology. Clin Dermatol 2004;22:303–309.
- Naldi L, Colombo P, Placchesi EB, Piccitto R, Chatenoud L, La Vecchia C, and the Praktis Study Centers: Study design and preliminary results from the pilot phase of the PraKtis Study: self-reported diagnoses of selected skin diseases in a representative sample of the Italian population. Dermatology 2004;208:38–42.
- Antic M, Conen D, Itin PH: Teaching effects of dermatological consultation on nondermatologists in the field of internal medicine: a study of 1,290 inpatients. Dermatology 2004;208:32–37.
Garcia-Humbria L, Richard-Yegres N, Perez-Blanco M, Yegres F, Mendoza M, Acosta A, Hernandes R, Zarraga E: Superficial mycoses: comparative study between type 2 diabetic patients and a non-diabetic control group. Invest Clin 2005;46:65–74.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.