Tropical diabetic hand syndrome

This is an automatically translated article.

The article was written by Specialist Doctor I Vo Khac Khoi Nguyen - Orthopedic surgeon, General Surgery Department - Vinmec Central Park International General Hospital.
Diabetic hand infection is also known as tropical diabetic hand syndrome. The disease is easy to occur in the tropics because the hot and humid climate creates favorable conditions for bacteria to grow. This is often the result of a common hand injury but is not treated promptly and adequately.

1. One of the rare but serious diseases

Diabetic hand complications are less common than foot complications. The ratio of hand to foot complications is 1:20. But the mortality rate of diabetic hands is up to 13% due to sepsis.
Tropical diabetic hand syndrome is an acute complicated hand infection complication in a diabetic in the tropics. The entry of germs into the body is usually after a minor injury to the hand. This pathology occurs mainly in diabetic patients living in tropical or coastal areas.
The clinical presentation of this syndrome is diverse: from swelling, local cellulitis, with or without hand ulceration, to progressive hand infection, to necrosis affecting the entire limb, even even can cause death. Tropical diabetic hand syndrome can lead to permanent disability and death due to delays in diagnosis, treatment, and late surgical intervention.
Independent risk factors for this syndrome include poorly controlled diabetes, peripheral neuropathy, female gender, insect bites, hand trauma, low socioeconomic status, resident in coastal areas and treated late.
It should be noted, tropical diabetic hand syndrome is not usually classified among specific diabetic complications. Cases are sporadic, so they are not commonly reported in the literature. Therefore, this syndrome is easily overlooked by patients and is not known to many doctors.

2. Simple onset but complicated consequences

Infections and ulcers are still the main causes of disability and death in patients with diabetes, especially in countries with hot and humid tropical climates like ours.
The onset is usually a minor injury or injury to the diabetic hand. However, underdiagnosed patients, delayed medical examination, and late initiation of treatment are common problems in patients with tropical diabetic hand syndrome.
This is due to low socioeconomic status, limited access to medical care, or the patient's lack of awareness of the potential risks associated with hand infections. This is the spiral that often causes patients to be hospitalized at a late and serious stage.

In addition, patients often tend to treat at home, self-administer antibiotics, or use folk remedies, which should contribute to the resistance of pathogenic bacteria strains.
Since the first report of tropical diabetic hand syndrome in Africa in 1984, to date, reports of this disease have been modest compared with other complications in diabetics. As a result, very few doctors and patients know about this syndrome and properly understand its severity.
Diabetic hand injuries are more common in manual workers than in men. Unlike diabetic foot infections, there is currently no uniformly applied grading scale for Tropical Diabetic Hand Syndrome. Initial treatment requires intravenous broad-spectrum antibiotics in addition to supportive measures to improve the patient's general condition. Surgery will be considered when removing foci of pus and necrotic tissue.
Although diabetic hand syndrome is a relatively uncommon complication of diabetes, it can be fatal. Early diagnosis and appropriate treatment will bring good outcomes for patients.

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