Skin disorders in diabetes mellitus

Diabetes mellitus, a major cause of mortality and morbidity, is often accompanied by skin manifestations. We will discuss the most common skin conditions faced by diabetic patients.

Post-drug adverse reactions

Insulin:
- Local
lipodystrophy with decreased adipose tissue at the injection site
arthus-like reaction with the appearance of urticarial lesions at the injection site
- General:
hives
serum sickness-type reactions

The oral hypoglycemic agents:
* Rash, fever
* Hives
* Erythema multiforme, photosensitivity

Infections

Poorly controlled diabetes is associated with increased crude incidence of infections (boils, carbuncule) or secondary (perionixis, superinfection of wounds / ulcers) with Staphylococcus aureus and other infections: cellulitis, skin or nail fungal infections, skin or mucosal candidiasis .

Necrobiosis

Paroximativ affects 0.3 to 3% of patients with diabetes, but not always associated with this condition. Necrobiosis lipoidice occurred appears to be an alteration in the collagen. The severity of the lesion did not correlate with the severity of diabetes and its control did not influence the evolution of skin disease.

Skin lesions occur in the anterior and lateral sides of the legs and have a characteristic appearance. They are well circumscribed, slightly elevated with the periphery and reddish brown hue, while the center has a yellowish tint. Ulcers can occur in lesions that are accompanied by local pain and heal with atrophic scars.

Peripheral neuropathy

Diabetic peripheral neuropathy is responsible for the appearance of “diabetic foot”. Is mixed, both motor and sensory. Motor neuropathy leads to weakness and distal muscle atrophy. Sensory neuropathy predisposes to the development of neuropathic ulcers of the leg bone protrusions, such as thumb or foot. Skin ulcers can spread to bone and joints, causing osteomyelitis. Also, the neuropathy can lead to anhidrosis (lack of sweating), not necessarily limited to distal extremities.

Peripheral Vasculopatia

Microangiopathy or affecting small vessels (arterioles, and capillaries venue) presents clinically as erythematous lesions and edematiate like erysipelas, with or without ulceration.

Impaired ischemia is seen in the large vessels, most often symptomatic in the calves and feet with gangrene and ulcers are prone to infections.

Diabetic Dermopatia

It translates into atrophic areas on the front of the calf appeared asymptomatic, occurring in waves. As the old lesions resolve new ones may occasionally appear ulcers.

Bubbles diabetic

Large bubbles can occur spontaneously on legs, feet, hands and fingers sides back on a healthy skin, inflammatory baseless. When they break zemuinde leave behind erosions that heal in a few weeks.