Síndrome de mano diabética: un diagnóstico clínico frecuentemente olvidado

Abstract

BACKGROUND: Diabetic hand syndrome is a frequent complication and is little valued by health personnel. Classically it is described as osteoarticular abnormalities related to long-standing diabetes, poor metabolic control, and microvascular complications. However, other disorders, such as skin involvement, infection of the hand and entrapment of peripheral nerves are part of this illness. CLINICAL CASE: A 66-year-old man, with a history of long-standing type 2 diabetes mellitus, undergoing intensive insulin therapy, consulted for presenting non-painful blisters on the fingers and palms of both hands, associated with weakness, changes in sensitivity and rigidity of the same. He had microvascular complications due to nephropathy, retinopathy and diabetic neuropathy, his glycated hemoglobin was 10.9%. Physical examination documented semiological findings compatible with diabetic bullosis and diabetic cheiroarthropathy. CONCLUSIONS: Osteoarticular, dermatological and neuropathic involvement of the hand should be recognized by health personnel as a specific complication of long-standing diabetes. Its early detection is of great value to prevent its progression and guide the search for microvascular complications. The diagnosis of this entity is clinical; therefore, it is advisable to carry out a routine evaluation of the hands of the diabetic patient, in order to install multidisciplinary management that will improve the outcomes