Cutaneous Manifestations in Diabetes Mellitus
Diabetes mellitus is a metabolic disorder of great importance. 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. Despite prior investigations, the exact mechanisms of many cutaneous markers remain not fully explained. 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.
KeywordsDiabetes mellitus Skin Diabetic dermopathy Necrobiosis lipoidica Acanthosis nigricans Diabetic bullae Scleredema diabeticorum Kyrle’s disease Diabetic hand syndrome Diabetic foot syndrome
Hyperplasia of the squamous epithelium.
Dark pigmentation with a velvety texture in large skin folds.
Benign pedunculated skin growths usually occurring on the eyelids, neck, and axillae.
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.
Also known as “shin spots,” a specific skin condition associated with diabetes mellitus.
Redness of the skin together with a sensation of local warmth or burning.
A phenomenon where new lesions appear along a site of trauma or irritation of the skin can. Examples: lichen planus, psoriasis.
Inflammatory chronic skin condition of flat-topped erythematous to violaceous papules caused by an autoimmune process,
A change in the color of the skin that is neither raised nor depressed, up to 1 cm in diameter.
Pigment cells responsible for producing melanin. In the human skin they are found in the basal layer of the epidermis and hair follicles.
Gradual degeneration and death of a cell.
Skin disease marked by one or more tender yellowish brown patches often associated with diabetes mellitus.
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.
A dermatologic disorder characterized by hardening and thickening of the skin. When associated with diabetes mellitus is called “scleredema diabeticorum.”
An acquired pigmentary disorder of unknown origin characterized by portions of the skin losing their pigment.
Yellow pigmentation of the skin.
Commonly known as “dry skin,” results from a defect in the stratum corneum.
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