Structural and Functional Changes in Skin of the Diabetic Foot

  • YongJun Zheng
  • Bin Shu
  • Jianfang Fu
  • Antonios Kafanas
  • Aristidis VevesEmail author
Part of the Contemporary Diabetes book series (CDI)


Diabetes, especially type 2, is characterized by systemic inflammation. At the skin level, there is increased infiltration by inflammatory cells and polarization of the macrophages toward the M1 inflammatory type. In addition, there is increased expression of MMP-9 and protein tyrosine phosphatase-1B (PTP1B). Other dermatologic conditions include acanthosis nigricans, characterized by a hyperpigmented, velvety, cutaneous thickening that appears predominantly in the neck, axilla, and groin areas; necrobiosis lipoidica (NL), a chronic, necrotizing, granulomatous skin disease; granuloma annulare; diabetic bullae; and diabetic dermopathy. As these conditions can be present in the lower extremity, they should be sought and easily recognized by the health care providers who manage the diabetic lower extremity.


Skin inflammatory cells Macrophages Acanthosis nigricans Necrobiosis lipoidica Granuloma annulare Diabetic bullae Diabetic dermopathy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • YongJun Zheng
    • 1
  • Bin Shu
    • 2
  • Jianfang Fu
    • 3
  • Antonios Kafanas
    • 4
  • Aristidis Veves
    • 5
    Email author
  1. 1.Burns Center of Changhai Hospital, The Second Military Medical UniversityShanghaiChina
  2. 2.Burns DepartmentFirst Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina
  3. 3.Endocrinology DepartmentXijing Hospital, The Fourth Military Medical UniversityXi’anChina
  4. 4.Diagnostic Histopathology Centre, PathologySerresGreece
  5. 5.The Rongxiang Xu, MD, Center for Regenerative Therapeutics Research Director, Joslin-Beth Israel Deaconess Foot CenterBeth Israel Deaconess Medical CenterBostonUSA

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