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Diabetes and the Skin

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Abstract

Skin manifestations of diabetes mellitus are frequent. Symptoms vary from mild cosmetic concerns to disabling conditions. The skin signs are not always recognized though they can be a presenting symptom of diabetes mellitus or a marker of advanced disease. In this chapter, different skin manifestations and their pathogenesis are discussed, some of them more specific for Type 1 diabetes mellitus, others for Type 2 or both. Cutaneous side effects of medications used to treat diabetes mellitus are discussed as well. Several clinical and histopathological images are included.

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Authors and Affiliations

  1. Department of Dermatology, University Hospital Gent, Ghent, Belgium

    Justine Mestdagh

  2. Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Sterre Blanche Laura Koster & Hok Bing Thio

  3. Department of Pathology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Jeffrey Damman

Authors
  1. Justine Mestdagh
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  2. Sterre Blanche Laura Koster
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  3. Jeffrey Damman
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  4. Hok Bing Thio
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Correspondence to Hok Bing Thio .

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Editors and Affiliations

  1. Mexico City, Mexico

    Joel Rodriguez-Saldana

Glossary

Atrophy

A loss of tissue from the epidermis, dermis, or subcutaneous tissues. There may be fine wrinkling and increased translucency if the process is superficial.

Erythema

Redness of the skin produced by vascular congestion or increased perfusion.

Koebner phenomenon

The onset of new inflammatory skin lesions after minor trauma such as scratching.

Macula

A circumscribed alteration in the color of the skin.

Nodule

A solid mass in the skin, which can be observed as an elevation or can be palpated. It is more than 0.5 cm in diameter. It may involve epidermis and dermis, dermis and subcutis, or subcutis alone. It may consist of fluid, other extracellular material (e.g., amyloid), inflammatory, or neoplastic cells.

Papule

A circumscribed palpable elevation, less than 0.5 cm in diameter. By careful examination it is often possible to determine whether the thickening involves predominantly the epidermis or the dermis and what type of pathological process is concerned. The only distinction between a papule and a nodule is the size, and this is artificial; some lesions characteristically occur at the smaller size of a papule, whereas others typically enlarge from a papule to become a nodule. Recording a finite size is more useful.

Plaque

An elevated area of skin, usually defined as 2 cm or more in diameter. It may be formed by the extension or coalescence of either papules or nodules as in psoriasis and granuloma annulare, respectively. Small plaque is sometimes used for such lesions 0.5–2 cm in diameter.

Sclerosis

Diffuse or circumscribed induration of the subcutaneous tissues. It may also involve the dermis, when the overlying epidermis may be atrophic. It is characteristically seen in scleroderma, but may occur as a sequel to or in association with many different processes.

Ulcer

A loss of dermis and epidermis, often with loss of the underlying tissues.

Vesicles and bullae

Visible accumulation of fluid within or beneath the epidermis. Vesicles are small (less than 0.5 cm in diameter) and often grouped. Bullae, which may be of any size over 0.5 cm, should be subdivided as multilocular (due to coalesced vesicles, typically in eczema) or unilocular [91]

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Mestdagh, J., Koster, S.B.L., Damman, J., Thio, H.B. (2023). Diabetes and the Skin. In: Rodriguez-Saldana, J. (eds) The Diabetes Textbook. Springer, Cham. https://doi.org/10.1007/978-3-031-25519-9_61

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