Diabetic hand syndrome Please rate this page (bottom of page)

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Diabetic hand syndrome with crooked fingers tested by palm imprint test. Hashim K, Thomas M, Indian Journal of Anesthesia, (2014). CC BY-NC-SA 3.0

Definition

Diabetes mellitus can cause characteristic changes in both hands. The symptoms must be separated systemic connective tissue disease, especially scleroderma / systemic sclerosis.

Occurrence

Insulin-dependent diabetes mellitus is a risk factor, but the condition also occurs among otherwise healthy. In diabetes, diabetic hand syndrome is seen in 8-50%, especially after severely manageable disease over several years.

Disease Cause

Most have had insulin-requiring diabetes mellitus for several years. Increased prevalence among those with difficult to control diabetes. The disease process results in increased connective tissue (collagen) which is not degraded. In addition, changes in small blood vessels (microangiopathy) which affects blood circulation skin and subcutaneous tissue.

Symptoms

Examinations

An early research finding is that fingers cannot be stretched when the palm is placed against a table surface. Similarly, the fingers remain bent when the palms are placed against each other ("Prayers sign").

Dupuyten's contracture is often easily recognizable in the palm of your hand. Both hands need not be attacked. Blood tests, inclusive Antinuclear Factors (ANA) with subgroups (Scl70, CENP) expected to be normal.

Incorrect diagnosis (similar diseases, differential diagnoses)

Diabetic hand syndrome can be mistaken for scleroderma / systemic sclerosis. However, in diabetic hand syndrome is not expected Raynaud's phenomenon, telangiectasia, calcinosis (lime under the skin) or other facial and skin changes. Capillaroscopy is usually normal, without megapapillaries and bleeding, such as in systemic sclerosis.

Treatment

The best regulation of blood sugar is preventive and can better the changes at an early stage. Stretches to stretch your fingers can have an effect. In some cases, hand surgery is necessary, but one must be aware that the complication risk of diabetes is greater than that of otherwise healthy ones that are treated for Dupuytren's contracture or trigger finger.

Literature

Goyal A, Cureus, 2018


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