From the Guidelines
SGLT2 inhibitors can affect the skin, increasing the risk of genital mycotic infections, such as vulvovaginal candidiasis in women and balanitis in men, with an estimated increase of +0.9% [@@4@@].
- The increased risk of genital mycotic infections can be lowered with meticulous attention to personal hygiene, and topical antifungal agents can be used for initial treatment [@@2@@].
- SGLT2 inhibitors have also been associated with a rare but serious risk of necrotizing fasciitis of the perineum (Fournier’s gangrene), which can be life-threatening [@@1@@].
- Additionally, SGLT2 inhibitors may contribute to volume depletion, and patients should be advised to monitor for signs of volume depletion, such as orthostatic lightheadedness [@@2@@].
- The risk of hypoglycemia is not significantly increased with the addition of SGLT2 inhibitors in patients who are not taking either insulin or an insulin secretagogue [@@2@@].
- Other skin-related adverse effects, such as rash, urticaria, and angioedema, have been reported, although these are relatively rare [@@1@@, @@2@@].
- It is essential to note that the risk of lower limb amputation has been noted with canagliflozin, and caution is advised when prescribing this medication to patients with a history of prior amputations, significant peripheral artery disease, or active lower extremity soft tissue ulcers or infections [@@2@@, @@5@@].
From the Research
SGLT2 Inhibitors and Skin Effects
- There is no direct evidence in the provided studies that SGLT2 inhibitors have a significant impact on the skin 1, 2, 3, 4, 5.
- The studies primarily focus on the efficacy and safety of SGLT2 inhibitors in treating type 2 diabetes mellitus, highlighting their benefits in glycemic control, weight loss, and cardiovascular outcomes.
- Adverse events reported in the studies include urinary tract and genital infections, which may be related to the drug's mechanism of action but do not specifically mention skin effects 1, 2, 3, 5.
- One study mentions the risk of lower-extremity amputation and bone fracture associated with canagliflozin, but this is not directly related to skin effects 4.
- Another study discusses the safety of SGLT2 inhibitors, mentioning urogenital infections and other adverse events, but does not specifically address skin effects 5.