Frequency, Spectrum, and Predictors of Skin, Hair, and Nail Manifestations in Patients with Type 2 Diabetes Mellitus

Abstract

ABSTRACT Background: Skin disease in type 2 diabetes mellitus (T2DM) is very commonly reported in literatures. However, spectrum of hair and nail diseases besides skin diseases in patients with T2DM is less documented. Objectives: To see the frequency, spectrum, and predictors of skin, hair, and nail disease among patients with T2DM. Materials and Methods: This cross-sectional study included 172 patients with known T2DM at endocrine outpatient department by consecutive convenient sampling. All cases were interviewed and examined by a specialist dermatologist with adequate light exposure. Data were analyzed by SPSS version 25. Results: Among the study participants (age: 47.4 ± 12.4 year, mean ± standard deviation [SD], female: 119, 69.2%; body mass index: 25.6 ± 4.4 kg/m2 ± SD, uncontrolled DM: 83.0%), any form of skin, hair, and nail disease was present in 70.9% (122), 7.0% (12), and 13.4% (23) of cases, respectively. Pruritus was the most common (30.2%) skin manifestation, followed by xerosis (26.7%), acrochordons (14.5%), fungal infection (12.8%), and cherry angiomas (8.1%); whereas, nail dystrophy (8.1%) and onychomycosis (8.1%) were the most common nail diseases, followed by paronychia (2.9%). Diffuse hair loss observed in 7.0% of participants. We did not find any significant difference in the frequency of skin and hair disease between male and female (P = 0.276 and 0.347, respectively); however, we observed that higher number of females was suffered from different types of nail disease (16.8% vs. 5.7%; P = 0.047). DM duration >5 years was found to be a risk factor for diffuse hair loss (OR 1.80; 95% CI: 1.33–2.44, P = 0.013) and paronychia (OR: 2.11; 95% CI: 1.80–2.48, P = 0.026). The presence of hypertension is a risk factor for xerosis (OR: 1.55; 95% CI: 1.21–1.96, P = 0.002) and acrochordons (OR: 1.53; 95% CI: 1.19–1.96, P = 0.01). Conclusion: Alarmingly high frequency of skin, hair, and nail disease in T2DM needs special attention while managing T2DM.