There are several skin manifestations of a patient with diabetes mellitus. Research shows that about 30% of the patients with diabetes have some cutaneous disorders. Proper control of metabolic activities may prevent some of these manifestations. Most of the commonly encountered problems are listed below.
Necrobiosis lipoidica diabeticorum:
It is a degenerative disease of collagen. Around 0.3-0.7% of the people with diabetes develops these lesions. It affects females more than males. It usually occurs in lower legs, lesions are rarely found on the head trunk, arms, palm and soles. Initial lesion may be red-brown and later progress to yellow, waxy, depressed atrophic and slightly raised plaque.
The real caused is still unknown. The lesions are usually asymptomatic but can be itchy and painful sometimes. There is no specific treatment therapy for Necrobiosis lipoidica diabeticorum. Several treatment modalities are being used currently which are topical, intralesional or systemic corticosteroids and nonsteroidal anti-inflammatory agents. Some papers have stated laser surgery with some success.
Acanthosis Nigricans:
Acanthosis Nigricans is a skin disorder characterized by darkening and thickening of the skin. It usually affects the area of skin folds mainly armpits, posterior neck and groin.
The exact mechanism for acanthosis nigricans is also unclear. But it is often associated with increase in insulin level as in diabetes.
There is no specific treatment modality for acanthosis nigricans. Treatment measures are focuses on treating underlying cause and to improve cosmetic appearance. The darkening and thickening can be treated with topical retinoids, hydroquinone and cosmetic surgery like dermabrasion and laser therapy.
Diabetic Dermopathy:
Diabetes dermopathy is the most common cutaneous finding in a patient with diabetes. The lesions are usually seen in lower legs. These lesions are often bilateral and asymmetrical distribution.
The lesions are usually brown, round or oval and atrophic in nature. These lesions usually resolve spontaneously and scarring is common.
Diabetic Bullae:
Also known as Bullosis diabeticorum, diabetic bullae is a rare, spontaneous and non-inflammatory blistering condition. The exact cause is unclear.
These lesions usually appear on lower legs, especially plantar region. This is usually self limiting and no treatment may be required besides preventing secondary infection. The lesion heals spontaneously without scar formation.
Other skin manifestations that might be been in patient with diabetes are given below:
- Diabetic Ulcers
- Skin thickening
- Diabetic Ulcers
- Yellow skin and nails
- Eruptive xanthomas
- Perforating disorders
- Oral leukoplakia
- Infections like bacterial and fungal
- Disseminated granuloma annulare
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