Dimitriu Andreea MD
Cutaneuous manifestation of Diabetes Mellitus
Authors: Andreea Dimitriu, Laura Elena Paviliu
Diabetes mellitus is the most common endocrine disorder, accounting for 8.3% of the general population, and 79.2% of them have skin changes. Prevalence seems to be similar in both types of diabetes.
Diabetes can affect any part of the body, including the skin. Sometimes, skin involvement may be the first sign that a person has diabetes. Fortunately, many skin manifestations can be easily prevented and treated if they are discovered early.
Diabetes affects the skin through multiple mechanisms. Reaching high levels of glycemia leads to the formation of advanced glycation end products by glycation of proteins, lipids and nucleic acids. Advanced glycation end products cause multiple complications associated with diabetes including cutaneous complications. They also reduce the flexibility and solubility of collagen, contributing to the fibrotic process, skin aging, immune suppression, all of which are found in diabetics. Immune suppression associated with diabetes mellitus affects the healing mechanism, causing dysfunction of leukocyte and growth factors.
Skin manifestations in diabetes can be classified as: Metabolic skin manifestations (genital pruritus, eruption xanthoma, generalized pruritus), infectious (bacterial, fungal), vascular (macroangiopathy, microangiopathy, neuropathy), dermatological complications of diabetic treatment (abscesses, , lipoatrophy, lipohypertrophy, pruritus) and skin disorders aggravated by diabetes mellitus (acanthosis nigricans, acrochordons, diabetic bullosa, diabetic dermatopathy, annular granuloma, lipoid necrosis, scleredema diabeticorum, vitiligo).
The severity of cutaneous manifestations in diabetes mellitus is variable depending on the basic pathophysiology.
Early treatment of diabetes may reduce the risk of developing neuropathy, skin ulcers. Educating patients together with awareness of the importance of a healthy lifestyle including sports and diet plays an important role in the management and prevention of diabetes and related skin complications.
Optimal treatment and management of diabetes will improve the factors involved, reducing organ complications, improving quality of life.