Predictors of the development of chronic wound defects in the soft tissues of the lower extremities in the patients with type 1 diabetes mellitus and lipoid necrobiosis

A total of 50 patients presenting with type 1 diabetes mellitus (DM1) were available for the clinical and immunological examination. They were allocated to two groups, one comprised of 25 patients with DM1 and lipoid necrobiosis (LN), the other consisting of 25 patients with DM1 without LN. Expression of Toll-like receptors (TLR2, TLR3, and TLR4) was evaluated in monocytes and neutrophils obtained from peripheral blood. In addition, the state of peripheral circulation and innervation of the lower extremities was evaluated. It was shown that the impairment of expression and fluorescence of TLR2 and TLR4 in monocytes as well as TLR3 in neutrophils was associated with the manifestations of skin lesions in the patients with DM1 and LN. It is concluded that the measurement of Toll-like receptors in the patient presenting with type 1 diabetes mellitus and lipoid necrobiosis can be used in clinical practice for the prediction of the development of dermatosis.