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Giakoumaki M, Lambrou GI, Vlachodimitropoulos D, Tagka A, Vitsos A, Kyriazi M, Dimakopoulou A, Anagnostou V, Karasmani M, Deli H, Grigoropoulos A, Karalis E, Rallis MC, Black HS. Type I Diabetes Mellitus Suppresses Experimental Skin Carcinogenesis. Cancers (Basel) 2024; 16:1507. [PMID: 38672589 PMCID: PMC11048394 DOI: 10.3390/cancers16081507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
This study explores the previously uncharted territory of the effects of ultraviolet (UV) radiation on diabetic skin, compared to its well-documented impact on normal skin, particularly focusing on carcinogenesis and aging. Employing hairless SKH-hr2, Type 1 and 2 diabetic, and nondiabetic male mice, the research subjected these to UV radiation thrice weekly for eight months. The investigation included comprehensive assessments of photoaging and photocarcinogenesis in diabetic versus normal skin, measuring factors such as hydration, trans-epidermal water loss, elasticity, skin thickness, melanin, sebum content, stratum corneum exfoliation and body weight, alongside photo documentation. Additionally, oxidative stress and the presence of hydrophilic antioxidants (uric acid and glutathione) in the stratum corneum were evaluated. Histopathological examination post-sacrifice provided insights into the morphological changes. Findings reveal that under UV exposure, Type 1 diabetic skin showed heightened dehydration, thinning, and signs of accelerated aging. Remarkably, Type 1 diabetic mice did not develop squamous cell carcinoma or pigmented nevi, contrary to normal and Type 2 diabetic skin. This unexpected resistance to UV-induced skin cancers in Type 1 diabetic skin prompts a crucial need for further research to uncover the underlying mechanisms providing this resistance.
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Affiliation(s)
- Maria Giakoumaki
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - George I. Lambrou
- Choremeio Research Laboratory, First Department of Pediatrics, School of Health Sciences, Medical School, National and Kapodistrian University of Athens, Thivon & Levaeias 8, Goudi, 11527 Athens, Greece;
- Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, Thivon & Levadeias 8, 11527 Athens, Greece
| | - Dimitrios Vlachodimitropoulos
- Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias Street, 11527 Athens, Greece;
| | - Anna Tagka
- First Department of Dermatology and Venereology, ‘Andreas Syggros” Hospital, School of Medicine, National and Kapodistrian University of Athens, Ionos Dragoumi 5, 11621 Athens, Greece;
| | - Andreas Vitsos
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Maria Kyriazi
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Aggeliki Dimakopoulou
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Vasiliki Anagnostou
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Marina Karasmani
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Heleni Deli
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Andreas Grigoropoulos
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Evangelos Karalis
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Michail Christou Rallis
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Homer S. Black
- Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA;
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Perlamutrov YN, Svishchenko SI, Pugner AS. Scleroderma-like form of lipoid necrobiosis in a patient with idiopathic thrombocytopenic purpura. VESTNIK DERMATOLOGII I VENEROLOGII 2022. [DOI: 10.25208/vdv1302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
A 33-year-old female patient with idiopathic thrombocytopenic purpura complained of rashes on the skin of the lower extremities, accompanied by moderate itching and a feeling of skin tightness, as well as a histologically verified diagnosis of lipoid necrobiosis. A combined treatment was carried out with the glucocorticosteroid Methylprednisolone at a dose of 32 mg per day in combination with PUVA therapy with 0.3% solution of ammi majus fructuum furocumarines, with a positive effect in the form of a decrease in the color intensity and induction of rashes, under the control of platelet levels. When using the method of PUVA-therapy with 0.3% solution of ammi majus fructuum furocumarines, there was an improvement in the 8th phototherapy procedure, however, due to a decrease in the level of platelets in the blood, the course of phototherapy was suspended.
The method of PUVA therapy with 0.3% solution of ammi majus fructuum furocumarines turned out to be clinically effective in the treatment of lipoid necrobiosis, however, the presence of concomitant pathology in the patient requires an interdisciplinary approach to the choice of treatment tactics.
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Passanisi S, Salzano G, Lombardo F. Skin Involvement in Paediatric Patients with Type 1 Diabetes. Curr Diabetes Rev 2022; 18:e030921196145. [PMID: 34477525 DOI: 10.2174/1573399817666210903153837] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 11/22/2022]
Abstract
Skin involvement is an overlooked aspect in the management of paediatric patients with type 1 diabetes. A comprehensive search of published literature using the PubMed database was carried out using the following key terms: "children," "pediatric/paediatric patients," "skin," "skin disorders," "type 1 diabetes." Dermatological side effects are frequently observed among diabetic children and adolescents. Insulin-induced lipodystrophies and allergic contact dermatitis caused by insulin pumps or glycaemic sensors are the most common skin reactions in these patients. Furthermore, several diabetes-associated skin diseases such as necrobiosis lipoidica, granuloma annulare, vitiligo, and bullosis diabeticorum may already be present in paediatric patients. Paediatric diabetes specialists should pay attention to their patients' skin to recognize these disorders, identify the potential causes, and choose the most suitable treatment. Finally, the evaluation of skin concentrations of advanced glycation end-products using non-invasive diagnostic techniques may be used to assess the risk of chronic complications of diabetes as early as adolescence.
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Affiliation(s)
- Stefano Passanisi
- Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
| | - Giuseppina Salzano
- Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
| | - Fortunato Lombardo
- Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
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Lin C, Wei C, Lin C, Lin W, Kao C. Childhood type 1 diabetes may increase the risk of atopic dermatitis. Br J Dermatol 2015; 174:88-94. [PMID: 26370535 DOI: 10.1111/bjd.14166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 12/21/2022]
Affiliation(s)
- C.‐H. Lin
- Children's Hospital China Medical University Hospital Taichung Taiwan
- Department of Biomedical Imaging and Radiological Science China Medical University No. 2, Yuh‐Der Road Taichung 404 Taiwan
| | - C.‐C. Wei
- Children's Hospital China Medical University Hospital Taichung Taiwan
- College of Medicine China Medical University Hospital Taichung Taiwan
| | - C.‐L. Lin
- College of Medicine China Medical University Hospital Taichung Taiwan
- Management Office for Health Data China Medical University Hospital Taichung Taiwan
| | - W.‐C. Lin
- College of Medicine China Medical University Hospital Taichung Taiwan
- Department of Radiology China Medical University Hospital Taichung Taiwan
| | - C.‐H. Kao
- Graduate Institute of Clinical Medical Science School of Medicine College of Medicine China Medical University No. 2, Yuh‐Der Road Taichung 404 Taiwan
- Department of Nuclear Medicine and PET Center China Medical University Hospital Taichung Taiwan
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Sawatkar GU, Kanwar AJ, Dogra S, Bhadada SK, Dayal D. Spectrum of cutaneous manifestations of type 1 diabetes mellitus in 500 South Asian patients. Br J Dermatol 2014; 171:1402-6. [PMID: 24773124 DOI: 10.1111/bjd.13077] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Data on cutaneous manifestations of type 1 diabetes mellitus (DM) is scarce. OBJECTIVES To study the spectrum of dermatoses in patients with type 1 DM and the effects of disease duration and long-term glucose control on these cutaneous manifestations. SUBJECTS AND METHODS After prior consent, clinical examination and relevant investigations were done in 500 subjects with type 1 DM enrolled between July 2011 and June 2012. Statistical tests were performed using SPSS 16. The presence of various dermatoses was correlated with the duration of diabetes. RESULTS Of five hundred subjects, 339 (67·8%) had one or more dermatoses. The mean age of the patients was 16·9 ± 6·9 years (range 1-25 years) and mean total duration of diabetes was 4·43 ± 4·4 years. Cutaneous adverse effects related to insulin injections (CAII), comprising lipohypertrophy (41%), post-inflammatory hyperpigmentation (3%), lipoatrophy (0·6%) and acanthosis nigricans (0·4%), were the most common findings, followed by limited joint mobility (LJM) (16·8%), xerosis (15·8%) and scleroderma-like skin changes (10%). Patients having long-duration DM (> 4·4 years) were significantly more likely to have lipohypertrophy (P = 0·000), LJM (P = 0·000), scleroderma-like skin changes (P = 0·000), diabetic dermopathy (P = 0·000), acanthosis nigricans (P = 0·005) and skin tags (P = 0·002). Lipohypertrophy, LJM and scleroderma-like skin changes also showed significant correlation with blood glucose level. CONCLUSIONS Our study suggests that cutaneous changes are common in young Asian patients with type 1 DM. Information, education and counselling of patients and care givers, and awareness among physicians is essential for the prevention and early management of these dermatoses.
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Affiliation(s)
- G U Sawatkar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
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Remission of ulcerated necrobiosis lipoidica diabeticorum after bariatric surgery. Case Rep Dermatol Med 2013; 2013:352579. [PMID: 23762652 PMCID: PMC3670525 DOI: 10.1155/2013/352579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 04/23/2013] [Indexed: 01/06/2023] Open
Abstract
A 32-year-old woman with type 2 diabetes mellitus suffering from morbid obesity with BMI 45,14 kg/m(2) was operated on. Not only the type 2DM but also one of its complication known as necrobiosis lipoidica diabeticorum remitted postoperatively. Obesity should no longer be regarded simply as a cosmetic problem affecting certain individuals but an epidemic that threatens global well-being. It causes or exacerbates many health problems, and in particular, it is associated with the type 2 diabetes. Necrobiosis lipoidica is a granulomatous skin disease of unknown etiology, associated mainly with diabetes mellitus. We presented in this paper a morbid obese case of necrobiosis lipoidica diabeticorum with dramatic good response to bariatric surgery.
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Patsatsi A, Kyriakou A, Sotiriadis D. Necrobiosis lipoidica: early diagnosis and treatment with tacrolimus. Case Rep Dermatol 2011; 3:89-93. [PMID: 21577369 PMCID: PMC3094681 DOI: 10.1159/000327936] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We present a case of necrobiosis lipoidica (NL) with atypical early lesions and good response to topical tacrolimus. NL is a disease with clinical features that are seldom misinterpreted. Often histology just confirms the clinician's diagnosis. Only in rare cases, the clinical presentation and the involved body sites may be misleading. A 67-year-old diabetic woman was admitted to our department with a well-defined, persistent plaque on her left arm and on her right shin. Histologic examination of both lesions revealed features of NL despite the dissimilar clinical presentation. The patient was treated with 0.1% topical tacrolimus ointment twice daily for 8 weeks and once daily for 8 weeks. A significant improvement and no further lesions were observed after 1 year of follow-up. A high index of suspicion regarding NL lesions with atypical clinical presentation on different body sites is advised in order to avoid misdiagnosis, wrong treatment decisions and ulceration. Additionally, it appears that topical tacrolimus treatment is an effective therapeutic option in patients with recent, non-ulcerated NL lesions.
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Affiliation(s)
- A Patsatsi
- 2nd Department of Dermatology, Aristotle University School of Medicine, Thessaloniki, Greece
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