NECROTIZING DERMATITIS IN PATIENTS WITH DIABETES MELLITUS: CLINICAL AND PATHOGENETIC FEATURES AND TREATMENT APPROACHES

The aim of the study was to study the clinical and pathogenetic features of the course of necrotizing dermatitis in patients with diabetes mellitus and to develop approaches to its treatment. The study included 54 patients diagnosed with type 1 or type 2 diabetes mellitus who had various forms of necrotic skin lesions, including ulcerative necrotizing dermatitis, necrotizing fasciitis, and pyoderma. A comprehensive assessment of clinical data, glycemic profile, microbiological and immunological parameters, as well as treatment tactics was carried out. A direct relationship has been established between the degree of decompensation of carbohydrate metabolism and the severity of dermatological complications. Patients with severe hyperglycemia and signs of secondary immunodeficiency had severe necrotic forms with a high risk of septic complications. The combined use of surgical debridement, systemic antibiotic therapy and immunomodulators contributed to a significant improvement in clinical outcomes. The data obtained emphasize the need for early diagnosis and a multidisciplinary approach to the treatment of this category of patients.