title: [Advances in research of the mechanism of "covert disorder" in diabetic skin].
abstract: The diabetic ulceration is not uncommon, and becomes refractory, as the skin in a diabetic patient is relatively thin as well as hypoesthetic and less sensitive to temperature. As there are already preexisting histological and cellular derangement in the skin, healing of the skin injury is difficult, thus resulting in an intractable ulceration. When diabetes is not controlled, the skin contents of sugar and advanced glycation end product accumulate, invoking cellular deformation and accumulation of matrix metalloproteinases (MMP), resulting in an imbalance between MMP and its inhibitors, malfunction of growth factors, and inflammatory reaction. These processes lead to obvious skin thinning, denaturation of connective tissues, thickening of vascular basal membrane, and neuropathy, etc. These pathological alterations could be recognized as "covert disorder" of skin in diabetic patients and may be underlying disorders in producing indolent diabetic ulcers.
authors.affiliation: Department of Burns and Plastic Surgery, Nanjing Medical University, Nanjing, China.
authors.forename: Xiao-jing
authors.initials: XJ
authors.lastname: Ge
authors.forename: Yu-zhi
authors.initials: YZ
authors.lastname: Jiang
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Zhang
mesh_terms: D000818:Animals; D003920:Diabetes Mellitus / Q000378:metabolism / Q000473:pathology*; D017127:Glycation End Products, Advanced / Q000378:metabolism; D051381:Rats; D012867:Skin / Q000378:metabolism / Q000473:pathology*; D012883:Skin Ulcer / Q000473:pathology; D014945:Wound Healing
chemical_list: D017127:Glycation End Products, Advanced