Subclinical skin stiffening in adults suffering from type 1 diabetes mellitus. A comparison with Raynaud's syndrome

Abstract

Acral skin of patients suffering from either type 1 diabetes mellitus or Raynaud's syndrome may become stiffer than normal. Such changes have not yet been thoroughly assessed using biometrological methods. The purpose of this study was to compare the mechanical properties of skin in these two conditions. Subclinical alterations were looked for on the back of the hands. We used an in vivo suction device equipped with two probes measuring skin extensibility and elasticity of the superficial and deep layers of the skin, respectively. A total of 58 middle aged adults with type 1 diabetes, 26 patients suffering from Raynaud's syndrome and 50 sex- and age-matched healthy volunteers participated in the study. There is evidence that both diseases affect the biomechanical properties of the dermis and of the underlying tissues. The dual changes are apparently opposite, corresponding to a superficial dermal laxity while the deep dermo-hypodermal tissues show some stiffening. From a biomechanical point of view, type 1 diabetes aggravates skin ageing and is also responsible for a subclinical skin stiffening in many patients. Raynaud's syndrome shows similar changes although the skin ageing effect is less prominent and the skin stiffening more frequent.