{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:37:28Z","timestamp":1791877048522,"version":"4.3.4"},"reference-count":47,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The skin is an important indicator of overall health, and its relationship with insulin resistance (IR) and metabolic syndrome (MetS) has garnered increasing attention. This review explores the connection between glucose dysregulation and various dermatological conditions, aiming to highlight integrative approaches for management. Methods: A comprehensive literature search was conducted in June and July 2024 across PubMed, Google Scholar, and Embase. Peer-reviewed studies on glucose dysregulation in dermatology were identified using terms such as \u201cinsulin,\u201d \u201cmetabolic syndrome,\u201d and \u201cdermatological manifestations.\u201d Relevant studies were selected based on their contributions to understanding these relationships. Results: The review identified significant associations between glucose dysregulation, MetS, and conditions such as psoriasis, acne, acanthosis nigricans, seborrheic dermatitis, and hidradenitis suppurativa. Key findings indicated that elevated insulin levels and inflammatory markers correlate with the severity of these skin disorders. Notably, dietary interventions and probiotics show potential in modulating inflammation and improving metabolic health. Conclusions: There is a clear link between glucose dysregulation and several dermatological conditions, underscoring the importance of a holistic treatment approach. By addressing glucose control and incorporating lifestyle modifications, clinicians can improve patient outcomes and mitigate the complications associated with IR and MetS. Further research is essential to refine these integrative strategies and assess their effectiveness in clinical practice.<\/jats:p>","DOI":"10.3390\/jcm15010330","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T11:11:46Z","timestamp":1767352306000},"page":"330","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Insulin Resistance, Metabolic Syndrome, and Inflammatory Skin Disease"],"prefix":"10.3390","volume":"15","author":[{"given":"Krisha","family":"Tripathy","sequence":"first","affiliation":[{"name":"Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay S.","family":"Dulai","sequence":"additional","affiliation":[{"name":"Integrative Skin Science and Research, Sacramento, CA 95815, USA"},{"name":"Integrative Research Institute, Sacramento, CA 95819, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6201-7401","authenticated-orcid":false,"given":"Mildred","family":"Min","sequence":"additional","affiliation":[{"name":"Integrative Skin Science and Research, Sacramento, CA 95815, USA"},{"name":"Integrative Research Institute, Sacramento, CA 95819, USA"},{"name":"College of Medicine, California Northstate University, Elk Grove, CA 95757, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7205-8162","authenticated-orcid":false,"given":"Raja K.","family":"Sivamani","sequence":"additional","affiliation":[{"name":"Integrative Skin Science and Research, Sacramento, CA 95815, USA"},{"name":"Integrative Research Institute, Sacramento, CA 95819, USA"},{"name":"College of Medicine, California Northstate University, Elk Grove, CA 95757, USA"},{"name":"Pacific Skin Institute, Sacramento, CA 95815, USA"},{"name":"Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1210\/er.2008-0024","article-title":"The metabolic syndrome","volume":"29","author":"Cornier","year":"2008","journal-title":"Endocr. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1576","DOI":"10.1002\/hsr2.1576","article-title":"Association between metabolic syndrome and prevalent skin diseases: A systematic review and meta-analysis of case-control studies","volume":"6","author":"Sodagar","year":"2023","journal-title":"Health Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Brazzelli, V., Maffioli, P., Bolcato, V., Ciolfi, C., D\u2019ANgelo, A., Tinelli, C., and Derosa, G. (2021). Psoriasis and Diabetes, a Dangerous Association: Evaluation of Insulin Resistance, Lipid Abnormalities, and Cardiovascular Risk Biomarkers. Front. Med., 8.","DOI":"10.3389\/fmed.2021.605691"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.2147\/CCID.S422355","article-title":"Higher IL-9 Level is Associated with Psoriasis Vulgaris Complicated by Metabolic Syndrome","volume":"16","author":"Yan","year":"2023","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"325","DOI":"10.4161\/gmic.25487","article-title":"Bifidobacterium infantis 35,624 modulates host inflammatory processes beyond the gut","volume":"4","author":"Groeger","year":"2013","journal-title":"Gut Microbes"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Adawi, M., Watad, A., Brown, S., Aazza, K., Aazza, H., Zouhir, M., Sharif, K., Ghanayem, K., Farah, R., and Mahagna, H. (2017). Ramadan Fasting Exerts Immunomodulatory Effects: Insights from a Systematic Review. Front. Immunol., 8.","DOI":"10.3389\/fimmu.2017.01144"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Adawi, M., Damiani, G., Bragazzi, N.L., Bridgewood, C., Pacifico, A., Conic, R.R.Z., Morrone, A., Malagoli, P., Pigatto, P.D.M., and Amital, H. (2019). The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study. Nutrients, 11.","DOI":"10.3390\/nu11030601"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1089\/met.2022.0073","article-title":"Prevalence of Metabolic Syndrome and Insulin Resistance in Adult Patients with Acne: Association with Traditional Cardiovascular Risk Factors and Acne Severity","volume":"21","author":"Carneiro","year":"2023","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Yang, J., Yang, H., Xu, A., and He, L. (2020). A Review of Advancement on Influencing Factors of Acne: An Emphasis on Environment Characteristics. Front. Public. Health, 8.","DOI":"10.3389\/fpubh.2020.00450"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"209","DOI":"10.4103\/cdr.cdr_56_21","article-title":"Holistic Approach to Management of Acne: Exploring the Evidence","volume":"7","year":"2023","journal-title":"Clin. Dermatol. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6209","DOI":"10.1111\/jocd.15210","article-title":"The potential role of insulin-like growth factor 1 in acne vulgaris and its correlation with the clinical response before and after treatment with metformin","volume":"21","author":"Albalat","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_12","unstructured":"Brady, M.F., and Rawla, P. (2024). Acanthosis Nigricans, StatPearls Publishing LLC."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.mjafi.2024.04.011","article-title":"Review of facial acanthosis nigricans: Easy to diagnose and difficult to treat marker of hyperinsulinemia\/metabolic syndrome","volume":"80","author":"Verma","year":"2024","journal-title":"Med. J. Armed Forces India"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4720","DOI":"10.1210\/jc.2010-0630","article-title":"Circulating pigment epithelium-derived factor levels are associated with insulin resistance and decrease after weight loss","volume":"95","author":"Sabater","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_15","first-page":"50","article-title":"Insulin Resistance and Metabolic Syndrome in Patients with Seborrheic Dermatitis: A Case-Control Study","volume":"20","year":"2022","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_16","first-page":"213","article-title":"The Association Between Hidradenitis Suppurativa and Diet: An Update","volume":"31","year":"2023","journal-title":"Acta Dermatovenerol. Croat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1111\/ijd.17101","article-title":"Evaluating dietary considerations in hidradenitis suppurativa: A critical examination of existing knowledge","volume":"63","author":"Vural","year":"2024","journal-title":"Int. J. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Boehncke, W.-H. (2018). Systemic inflammation and cardiovascular comorbidity in psoriasis patients: Causes and consequences. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00579"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1002\/eji.201848027","article-title":"Peripheral neurons: Master regulators of skin and mucosal immune response","volume":"49","author":"Basso","year":"2019","journal-title":"Eur. J. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1159\/000529359","article-title":"Metformin in Hidradenitis Suppurativa: Is It Worth Pursuing Further?","volume":"9","author":"Tsentemeidou","year":"2023","journal-title":"Skin. Appendage Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"adv00645","DOI":"10.2340\/actadv.v101.1012","article-title":"Systematic Review and Meta-analysis of the Association Between Metabolic Syndrome and Androgenetic Alopecia","volume":"102","author":"Qiu","year":"2022","journal-title":"Acta Derm. Venereol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/S0140-6736(00)02763-X","article-title":"Early androgenetic alopecia as a marker of insulin resistance","volume":"356","author":"Matilainen","year":"2000","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"276","DOI":"10.4103\/2229-5178.137776","article-title":"Androgenetic alopecia, metabolic syndrome, and insulin resistance: Is there any association? A case-control study","volume":"5","author":"Bakry","year":"2014","journal-title":"Indian. Dermatol. Online J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mehy.2019.03.003","article-title":"Male PCOS equivalent and nutritional restriction: Are we stepping forward?","volume":"126","author":"Cerana","year":"2019","journal-title":"Med. Hypotheses"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1001\/jamadermatol.2016.1776","article-title":"A Comparison of the Hormonal Profile of Early Androgenetic Alopecia in Men With the Phenotypic Equivalent of Polycystic Ovarian Syndrome in Women","volume":"152","author":"Sanke","year":"2016","journal-title":"JAMA Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jaad.2010.05.002","article-title":"Sex hormone-binding globulin and risk of hyperglycemia in patients with androgenetic alopecia","volume":"65","year":"2011","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1210\/jcem-62-5-904","article-title":"Insulin stimulates androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism","volume":"62","author":"Barbieri","year":"1986","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"113643","DOI":"10.1016\/j.ygcen.2020.113643","article-title":"A closer look at the role of insulin for the regulation of male reproductive function","volume":"300","author":"Oghbaei","year":"2021","journal-title":"Gen. Comp. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3321","DOI":"10.1096\/fj.201700769RR","article-title":"Insulin and IGF1 receptors are essential for the development and steroidogenic function of adult Leydig cells","volume":"32","author":"Neirijnck","year":"2018","journal-title":"FASEB J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"15937","DOI":"10.1074\/jbc.M113.451773","article-title":"Insulin directly regulates steroidogenesis via induction of the orphan nuclear receptor DAX-1 in testicular Leydig cells","volume":"288","author":"Ahn","year":"2013","journal-title":"J. Biol. Chem."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jdcr.2024.06.001","article-title":"Treatment of insulin resistance with tirzepatide leading to improvement of hair loss","volume":"50","author":"Gordon","year":"2024","journal-title":"JAAD Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"73S","DOI":"10.1097\/00006250-198409001-00019","article-title":"Insulin stimulates androgen accumulation in incubations of human ovarian stroma and theca","volume":"64","author":"Barbieri","year":"1984","journal-title":"Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/j.jaad.2022.01.009","article-title":"American Academy of Dermatology Guidelines: Awareness of comorbidities associated with atopic dermatitis in adults","volume":"86","author":"Davis","year":"2022","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1111\/dom.14146","article-title":"Normal insulin sensitivity, glucose tolerance, gut incretin and pancreatic hormone responses in adults with atopic dermatitis","volume":"22","author":"Gether","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1111\/jdv.15642","article-title":"Atopic dermatitis and the metabolic syndrome: A cross-sectional study of 116 816 patients","volume":"33","author":"Shalom","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2340\/00015555-2441","article-title":"Association Between Metabolic Syndrome and Atopic Dermatitis in Korean Adults","volume":"97","author":"Lee","year":"2017","journal-title":"Acta Derm. Venereol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3912","DOI":"10.1529\/biophysj.107.122531","article-title":"Osmotic water transport with glucose in GLUT2 and SGLT","volume":"94","author":"Naftalin","year":"2008","journal-title":"Biophys. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1055\/s-2007-1003339","article-title":"Osmotic stress due to changes in plasma glucose and its regulation in IDDM patients","volume":"24","author":"Khalaf","year":"1992","journal-title":"Horm. Metab. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"25263","DOI":"10.1073\/pnas.2009072117","article-title":"Diffusioosmotic and convective flows induced by a nonelectrolyte concentration gradient","volume":"117","author":"Williams","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ono, E., Murota, H., Mori, Y., Yoshioka, Y., Nomura, Y., Munetsugu, T., Yokozeki, H., and Katayama, I. (2018). Sweat glucose and GLUT2 expression in atopic dermatitis: Implication for clinical manifestation and treatment. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195960"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1080\/09546634.2016.1278071","article-title":"Dietary modifications in atopic dermatitis: Patient-reported outcomes","volume":"28","author":"Nosrati","year":"2017","journal-title":"J. Dermatol. Treat."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1111\/j.1468-3083.2009.03533.x","article-title":"Candida balanitis: Risk factors","volume":"24","author":"Lisboa","year":"2010","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.jdiacomp.2012.06.012","article-title":"Incidence of genital infection among patients with type 2 diabetes in the UK General Practice Research Database","volume":"26","author":"Hirji","year":"2012","journal-title":"J. Diabetes Complicat."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"115556","DOI":"10.1016\/j.diagmicrobio.2021.115556","article-title":"Reduction of susceptibility to azoles and 5-fluorocytosine and growth acceleration in Candida albicans in glucosuria","volume":"102","author":"Hiyama","year":"2022","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1590\/0074-02760170098","article-title":"New perspectives on the nutritional factors influencing growth rate of Candida albicans in diabetics. An in vitro study","volume":"112","author":"Man","year":"2017","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/S0140-6736(07)60917-9","article-title":"Vulvovaginal candidosis","volume":"369","author":"Sobel","year":"2007","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e00649-24","DOI":"10.1128\/mbio.00649-24","article-title":"A ketogenic diet enhances fluconazole efficacy in murine models of systemic fungal infection","volume":"15","author":"Palmucci","year":"2024","journal-title":"mBio"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/330\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:11:50Z","timestamp":1767589910000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/1\/330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15010330"],"URL":"https:\/\/doi.org\/10.3390\/jcm15010330","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]}}}