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Diabetes Mellitus

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Dermatology in Public Health Environments

Abstract

Diabetes mellitus is a metabolic disorder with notable impact on health systems worldwide. The corresponding pathomechanisms of this disease lead to repercussions in every organ system including the skin. Cutaneous manifestations as a consequence of diabetes are numerous and may even precede its diagnosis. Skin signs may also develop at any time over the course of the disease, helping physicians to identify previously undiagnosed diabetes cases. While some of these skin markers are indolent, others can result in great morbidity, occasionally affecting patients’ quality of life or leading to hospitalizations and life-threatening conditions. This chapter covers the clinical presentation, etiopathogenesis, and current therapeutic approach to the most common dermatologic manifestations specifically associated with diabetes mellitus such as diabetic dermopathy, necrobiosis lipoidica, acanthosis nigricans, granuloma annulare, diabetic bullae, scleredema diabeticorum, and Kyrle’s disease. Skin conditions not specifically related to diabetes and skin complications directly related to diabetes are also discussed.

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Abbreviations

AN:

Acanthosis nigricans

BD:

Bullosis diabeticorum

CN:

Charcot neuroarthropathy

DM:

Diabetes mellitus

DPN:

Diabetic peripheral neuropathy

EGFR:

Epidermal growth factor receptor

FGFR:

Fibroblast growth factor receptor

GA:

Granuloma annulare

IGF-1:

Insulin-like growth factor 1

KD:

Kyrle’s disease

LP:

Lichen planus

NL:

Necrobiosis lipoidica

SA:

Scleredema adultorum

SD:

Scleredema diabeticorum

STs:

Skin tags

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Glossary

Acanthosis

Hyperplasia of the squamous epithelium.

Acanthosis Nigricans

Dark pigmentation with a velvety texture in large skin folds.

Acrochordon

Benign pedunculated skin growths usually occurring on the eyelids, neck, and axillae.

Charcot foot

Complication in diabetes that is characterized by severe deformity of the foot and/or the ankle that when not detected early may result in secondary ulceration, infection, and amputation.

Diabetic dermopathy

Also known as “shin spots,” a specific skin condition associated with diabetes mellitus.

Flushing

Redness of the skin together with a sensation of local warmth or burning.

Koebner reaction

A phenomenon where new lesions appear along a site of trauma or irritation of the skin can. Examples: lichen planus, psoriasis.

Lichen planus

Inflammatory chronic skin condition of flat-topped erythematous to violaceous papules caused by an autoimmune process.

Macule

A change in the color of the skin that is neither raised nor depressed, up to 1 cm in diameter.

Melanocytes

Pigment cells responsible for producing melanin. In the human skin they are found in the basal layer of the epidermis and hair follicles.

Necrobiosis

Gradual degeneration and death of a cell.

Necrobiosis lipoidica

Skin disease marked by one or more tender yellowish brown patches often associated with diabetes mellitus.

Psoriasis

An autoimmune skin condition that changes the life cycle of skin cells. The majority of patients presents lesions as clearly defined red and scaly plaques.

Scleredema

A dermatologic disorder characterized by hardening and thickening of the skin. When associated with diabetes mellitus is called “scleredema diabeticorum.”

Vitiligo

An acquired pigmentary disorder of unknown origin characterized by portions of the skin losing their pigment.

Xanthoderma

Yellow pigmentation of the skin.

Xerosis

Commonly known as “dry skin,” results from a defect in the stratum corneum.

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Schons, K.R.R., Beber, A.A.C. (2023). Diabetes Mellitus. In: Rangel Bonamigo, R. (eds) Dermatology in Public Health Environments. Springer, Cham. https://doi.org/10.1007/978-3-031-13505-7_41

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