Diabetes mellitus (DM) is a chronic endocrine disease and is clinically divided into two parts: type-1 (insulin dependent) and type-2 (non-insulin dependent). More than 80% of diabetes mellitus patients consist of type-2 DM. Type-1 DM is usually seen before the age of 30. The main problem in diabetic patients is uncontrolled high blood sugar levels.
More than 30% of these patients may experience conditions such as skin dryness, itching, skin infections and delayed wound healing. Most of these skin problems are due to skin barrier functions, deterioration in skin metabolism, or complications such as vasculopathy (vascular disorders) and neuropathy (nerve damage) that occur as a result of diabetes. Skin findings in diabetes are generally seen in the advanced stages of the disease.
What are the skin findings seen in Diabetes Mellitus?
>1-Skin infections
The incidence of bacterial and fungal infections is higher in diabetic patients than in normal people. Staphylococcal infections such as furuncles, carbuncles (oriental boils), folliculitis (simple hair follicle infections), streptococcal infections such as erysipelas, lymphedema, and severe infections such as gangrene that result in death can be observed frequently if blood sugar levels are irregular, hygiene is not good, and vascular damage is present.
Candida Albicans, which is found as saprophyte in the skin flora, is responsible for fungal infections. Candida albicans can cause frequent fungal infections in the mouth and genital areas. Foot and groin fungus is more common in diabetic patients and the risk of recurrence after treatment is quite high. In addition, a skin disease called erythrasma, which causes itching, redness and burning in the armpits and groin, is a common skin disease in diabetic patients. Again, some severe systemic fungal diseases (mucormycosis, etc.) are diseases observed in this patient group and can sometimes be fatal.
2-Diabetic shin spot:
In diabetic patients, brown spots appear on the front of the legs. occur and these are called diabetic shin spot.
3-Necrobiosis Lipoidica:
Necrobiosis lipoidica, which is not frequently observed in these patients but is a very specific symptom of diabetes when seen, is another important skin finding. They are yellow, atrophic lesions in the middle on the front sides of the legs.
3-Granuloma Annulare:
Lesions called granuloma annulare, which are observed throughout the body in diabetics and have a hard consistency with non-itchy edges that are raised from the skin, are another symptom of diabetic skin involvement.
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4-Diabetic Ulcerations:
Due to vascular damage, these patients are diabetic. Ulcers may develop. These wounds, which can progress quite rapidly, can cause limb loss and death. Therefore, foot care and hygiene in diabetic patients is very important to prevent the development of these ulcers.
5- Neuropathic ulcers:
In diabetic patients, neuropathic ulcerations may develop in the slightest damage to the legs due to loss of sensation. Therefore, these patients need to be very careful when choosing shoes. It is best to seek professional help in foot care.
6- Diabetic bulla
Elderly diabetic. Patients may develop tense bullae on their legs without any cause. These bullae may not regress spontaneously in a few weeks. The use of topical antibiotic cream is usually necessary in case of infection.
7- Diabetic thick skin
Some In diabetic patients, contractions may develop in joint movements due to these thickenings, especially on the inner surfaces of the hands (diabetic stiff skin syndrome). Many small blisters form on the inner surfaces of the hands. The reason for their formation is antibodies against glutamic acid decarboxylase. are. These antibodies cause the development of contraction by increasing glycosylation and cross-linking in collagen.
8)-Scleredema adultorum:
It is a condition characterized by stiffness in the neck and back area. It is not a very specific picture for diabetes.
9)-Acanthosis Nigricans:
It is a condition caused by insulin resistance and hyperinsulinemia in diabetics. It occurs with darkening of the neck, armpits and groin and a velvety appearance on the skin.
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