Diyabetik Ayak Sendromunda Dermatolojik Bulgularının Değerlendirilmesi
Küçük Resim Yok
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Diyabetik hastalarda dermatolojik bulgular yaygın olarak görülür. Diyabetik ayak sendromu yüksek mortalite ve morbiditesi olan bir durumdur. Bu retrospektif çalışmada diyabetik ayak sendromu olan hastaların deri bulgularının sebep-sonuç ilişkilerini değerlendirmek, gelişebilecek komplikasyonları erken dönemde tanımak ve tedavi için doğru yönlendirmek amaçlanmıştır. Materyal ve Metod: Ege Üniversitesi Tıp Fakültesi Diyabetik Ayak Konseyinde takip ettiğimiz toplam 241 diyabetik ayak sendromlu hastanın dosyası incelendi. Hastaların cinsiyet, yaş, diyabet tipi ve süresi, HBA1c düzeyleri, infeksiyon varlığı ve tipi ile ülserlerinin Wagner sınıflaması ve deri bulgularından elde edilen veriler kaydedildi. Bu hastalar konseyin üyeleri olan dermatologlar tarafından değerlendirilip bulguları belirlendi. Bulgular: Hastalarda sıklık sırasına göre; 193 (%80.1) hastada kserozis, 80 (%33.2) hastada plantar hiperkeratoz, 54 (%22.4) hastada fissür, 55 (%22.8) hastada ayak parmak arasında maserasyon, 46 (%19.1) hastada kallus formasyonu, 8 (%3.3) hastada diyabetik dermopati ve 2 (%0.8) hastada diyabetik bül saptandı. Hastalarda mevcut ayak deformitelerine bakıldığında; 32 (%13.3) hastada ayak parmaklarında deformasyon, 89 (%36.9) hastada pençe ayak, 38 (%15.8) hastada çekiç parmak, 32 (%13.3) hastada akromegalik parmak, 23 (%9.5) hastada halluks valgus ve 22 (%9.1) hastada Charcot deformitesi saptandı. Ülserler Wagner sınıflamasına göre; 18 (%7.5) hastada Evre 1, 66 (%27.4) hastada Evre 2, 69 (%28.6) hastada Evre 3, 64 (%26.6) hastada Evre 4 ve 24 (%10) hastada Evre 5 olarak sınıflandırıldı. Altmış yedi (%27.8) hastada hafif infeksiyon, 114 (%47.3) hastada orta şiddette infeksiyon ve 60 (%24.9) hastada ciddi infeksiyon mevcuttu. Başvuru anında 114 (%47.3) hastada osteomiyelit saptanırken, 127 (%52.7) hastada saptanmadı. Sonuç: Diyabetli bir hastada deri bulgularının görülmesi daha sıkı hasta kontrolü gerekliliğini ve uygun ayak bakımı ihtiyacını göstermektedir. Diyabetik ayak sendromlu hastaların ayaktaki diğer deri bulgularıyla birlikte değerlendirilmesi erken tanı ve tedavi ile komplikasyon gelişmesini önleyecektir. Bu değerlendirme sonucu yüksek ekonomik maliyetlere neden olurken morbidite ve mortalitelerin azaltılmasını sağlayacaktır.
Introduction: Skin findings in diabetic patients are not rare. Diabetic Foot Syndrome (DFS) is associated with a high risk of morbidity and mortality. The purpose of this retrospective study is to evaluate the causal relationships of skin findings of DFS patients and to identify the complications that may develop early and to direct them for treatment. Materials and Methods: A total of 241 patient files followed in the Diabetic Foot Council of Ege University Medical Faculty with the diagnosis of DFS were examined. Data on gender, age, diabetes type and duration, HbA1c levels, presence and type of infection, Wagner’s classification, and skin findings of the patients were recorded. These patients were assessed by dermatologists, who were members of the Council, and their findings were recorded. Results: In terms of frequency, 193 (80.1%) patients had xerosis, 80 (33.2%) had plantar hyperkeratosis, 54 (22.4%) had fissure, 55 (22.8%) had maceration and desquamation between toes, 46 (19.1%) had callus formation, 8 (3.3%) had diabetic dermopathy, and 2 (0.8%) had diabetic bulla. In terms of foot deformities, 32 patients (13.3%) had deformation in toes, 89 (36.9%) had claw foot, 38 (15.8%) had hammer/claw toes, 32 (13.3%) had acromegalic finger, 23 (9.5%) had hallux valgus, and 22 (9.1%) had Charcot deformity. According to Wagner classification; 18 (%7.5) patients were Stage 1, 66 (%27.4) were Stage 2, 69 (%28.6) were Stage 3, 64 (%26.6) were Stage 4, and 24 (%10) were Stage 5. In terms of infection, 67 (%27.8) patients had mild infection, 114 (%47.3) had intermediate infection and 60 (%24.9) had severe infection. On time of admission, 114 (%47.3) patients had osteomyelitis but 127 (%52.7) did not. Conclusion: The appearance of skin findings in a diabetic patient indicates the need for more strict patient care and the need for proper foot care. Patients with DFS should be evaluated together with other skin findings on the foot which may prevent complications to occur thanks to early diagnosis and treatment. This will help reduce morbidity and mortality which can cause high economic costs.
Introduction: Skin findings in diabetic patients are not rare. Diabetic Foot Syndrome (DFS) is associated with a high risk of morbidity and mortality. The purpose of this retrospective study is to evaluate the causal relationships of skin findings of DFS patients and to identify the complications that may develop early and to direct them for treatment. Materials and Methods: A total of 241 patient files followed in the Diabetic Foot Council of Ege University Medical Faculty with the diagnosis of DFS were examined. Data on gender, age, diabetes type and duration, HbA1c levels, presence and type of infection, Wagner’s classification, and skin findings of the patients were recorded. These patients were assessed by dermatologists, who were members of the Council, and their findings were recorded. Results: In terms of frequency, 193 (80.1%) patients had xerosis, 80 (33.2%) had plantar hyperkeratosis, 54 (22.4%) had fissure, 55 (22.8%) had maceration and desquamation between toes, 46 (19.1%) had callus formation, 8 (3.3%) had diabetic dermopathy, and 2 (0.8%) had diabetic bulla. In terms of foot deformities, 32 patients (13.3%) had deformation in toes, 89 (36.9%) had claw foot, 38 (15.8%) had hammer/claw toes, 32 (13.3%) had acromegalic finger, 23 (9.5%) had hallux valgus, and 22 (9.1%) had Charcot deformity. According to Wagner classification; 18 (%7.5) patients were Stage 1, 66 (%27.4) were Stage 2, 69 (%28.6) were Stage 3, 64 (%26.6) were Stage 4, and 24 (%10) were Stage 5. In terms of infection, 67 (%27.8) patients had mild infection, 114 (%47.3) had intermediate infection and 60 (%24.9) had severe infection. On time of admission, 114 (%47.3) patients had osteomyelitis but 127 (%52.7) did not. Conclusion: The appearance of skin findings in a diabetic patient indicates the need for more strict patient care and the need for proper foot care. Patients with DFS should be evaluated together with other skin findings on the foot which may prevent complications to occur thanks to early diagnosis and treatment. This will help reduce morbidity and mortality which can cause high economic costs.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji, Enfeksiyon Hastalıkları
Kaynak
Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
1
