REVIEW   

Giornale Italiano di Dermatologia e Venereologia 2018 October;153(5):649-58

DOI: 10.23736/S0392-0488.18.06080-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Skin and diabetes: an experts' opinion from the Italian diabetologists and dermatologists of the DiaDex group

Aurora PARODI ¹ ✉, Michela CASTELLO ², Sabrina CORBETTA ³, Renzo CORDERA ^{4, 5}, Antonio CRISTAUDO ⁶, Rosa CUCCHIA ⁷, Valeria GUAZZONI ⁸, Miriam LEUZZI ⁹, Antoniomaria MUSSINI ^{10, 11}, Annalisa PATRIZI ^{9, 12}, Paolo PIGATTO ¹³, Roberto REGAZZINI ¹⁴, Daniele RIZZO ¹⁵, Luca STINGENI ⁷, Leonardo ZICHICHI ¹⁵

¹ Dermatology Clinic, San Martino Hospital and Institute for Research and Care, Genoa, Italy; ² Centro Medico Lombardo, Milan, Italy; ³ Endocrinology and Diabetology Service, Department of Biomedical Sciences for Health, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy; ⁴ Section of Endocrinology, School of Medicine, University of Genoa, Genoa, Italy; ⁵ Diabetes Unit, San Martino Hospital and Institute for Research and Care, Genoa, Italy; ⁶ IFO, San Gallicano Dermatological Institute, IRCCS, Rome, Italy; ⁷ Section of Clinical Dermatology, Allergology and Venereology, Department of Medicine, University of Perugia, Perugia, Italy; ⁸ Unit of Diabetology and Metabolic Diseases, Lodi Hospital, Lodi, Italy; ⁹ S. Orsola-Malpighi Polyclinic, Bologna University Hospital, Bologna, Italy; ¹⁰ Istituto De Rodolfi, Vigevano, Pavia, Italy; ¹¹ Vigevano and Lomellina Academy of Family Physicians, Vigevano, Pavia, Italy; ¹² School of Dermatology and Venerology, University of Bologna, Bologna, Italy; ¹³ Unit of Dermatology, Galeazzi Orthopedic Institute for Research and Care, Milan, Italy; ¹⁴ Unit of Dermatology, S. Anna Hospital, Como, Italy; ¹⁵ Unit of Dermatology, Sant’Antonio Abate Hospital, Trapani, Italy

The metabolic changes associated with diabetes mellitus (DM) affect a variety of organs and systems, including the skin. Skin lesions are frequently observed in patients with DM, resulting from a complex interaction among biochemical, vascular, immune, and metabolic changes. Cutaneous manifestations may develop at any time in the course of DM. They can be the first sign of the disease, possibly helping in diagnosis, or represent a marker of poor glycemic control. Given the high prevalence of cutaneous manifestations in DM, their possible role in favoring DM early diagnosis, and their relationship with the patient’s metabolic control, a group of Italian dermatologists and diabetologists, the DiaDex expert group, jointly formulated a few basic statements aimed at favoring a stricter interdisciplinary cooperation in order to improve patients’ management. Deeper knowledge of the skin lesions most commonly associated with DM, their early identification, and prompt reciprocal referral, when appropriate, are the pivotal points of these statements and should represent the pillars of such desired cooperation. The dermatologists and diabetologists of the DiaDex group believe that their different diagnostic and therapeutic skills put together may significantly benefit the many DM patients with cutaneous complications and hope that this paper may provide some guidance on how to achieve this goal.

KEY WORDS: Diabetes mellitus - Skin diseases - Interdisciplinary research - Disease management