In this article, we will talk about diabetes, symptoms of a photo, study the signs of diabetes, find out how ulcers and spots on the legs look in case of diabetes mellitus, and also see a rash in case of diabetes mellitus photo.
Symptoms of diabetes mellitus are varied, one in twentieth suffers from them. A large number of people have latent diabetes or a genetic predisposition to it. Therefore, it is important to be well aware of the signs of diabetes mellitus in order to consult a doctor for help in time.
Clinical picture
What doctors say about diabetes
Doctor of Medical Sciences, Professor Aronova S.M.
I have been studying the problem of DIABETES for many years. It is scary when so many people die, and even more become disabled due to diabetes mellitus.
I hasten to tell you the good news - the Endocrinological Research Center of the Russian Academy of Medical Sciences managed to develop a drug that completely cures diabetes mellitus. At the moment, the effectiveness of this drug is close to 100%.
More good news: the Ministry of Health has achieved the adoption of special program, for which the entire cost of the drug is reimbursed. Diabetics in Russia and CIS countries before can get a remedy IS FREE.
Learn more >>
Diabetes mellitus: signs and symptoms
An early sign of the disease may be the deterioration of the healing process of the most insignificant wounds. Boils and acne with diabetes(photo 2) also refer to early signals of trouble with the pancreas.
Itching in diabetes mellitus (photo below) is observed in 80% of cases.
Diabetes mellitus is indicated by increased pigmentation of skin folds and the appearance of small warts around them (acanthosis).
And such rashes on the skin with diabetes mellitus (photo in gal), as diabetic pemphigus, indicate a deep lesion of the skin and require surgical intervention.
Spots on the legs with diabetes mellitus
Dermatoses - spots on the legs with diabetes mellitus (in photo 3) - are more often located on the lower leg, but there are other favorite places of localization. White rounded spots in diabetes mellitus - vitiligo- serve as a signal for the development of the disease. Yellow seals - xanthomatosis - indicate an increase in blood sugar.
be careful
According to the WHO, every year 2 million people die from diabetes mellitus and the complications it causes in the world. In the absence of qualified support for the body, diabetes leads to various kinds of complications, gradually destroying the human body.
The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development of cancerous tumors. In almost all cases, a diabetic either dies fighting a painful illness or becomes a real disabled person.
What should people with diabetes do? The Endocrinological Research Center of the Russian Academy of Medical Sciences succeeded make a remedy completely curing diabetes mellitus.
Currently, the Federal Program "Healthy Nation" is underway, within the framework of which this drug is issued to every citizen of the Russian Federation and the CIS IS FREE... For details, see official website MINISTRY OF HEALTH.
Rashes in diabetes mellitus (photo in the gallery) can also be in the form of large cyanotic-red spots of irregular shape, prone to increase. Such signs of diabetes in women are much more common than in men. This is the so-called necrobiosis lipoid.
Gradually, on the lower legs, the skin becomes thin, rough and dry. With an increase in dystrophic processes, leg ulcers occur in diabetes mellitus (in photo 4). This process is facilitated by a decrease in sensitivity - minor abrasions and sores on the legs with diabetes mellitus (photo in gal) do not alert a person.
The main causes of occurrence ulcers in diabetes- these are previous bruises, calluses and microtrauma. But the true factors causing leg ulcers in diabetes mellitus, of course, lie much deeper in the violation of blood supply and innervation of the lower extremities. The ulcers become infected and spread over the surface of the leg.
Our readers write
Topic: Defeated diabetes
From whom: Lyudmila S ( [email protected])
To: Administration of my-diabet.ru
At the age of 47, I was diagnosed with type 2 diabetes. In a few weeks, I gained almost 15 kg. Constant fatigue, drowsiness, feeling of weakness, vision began to sit down. When I turned 66, I was already stably injecting myself with insulin, everything was very bad ...
And here is my story
The disease continued to develop, periodic attacks began, the ambulance literally returned me from the other world. All the time I thought that this time would be the last ...
Everything changed when my daughter let me read one article on the Internet. You can't imagine how grateful I am to her for that. This article helped me completely get rid of diabetes, a supposedly incurable disease. For the last 2 years I started to move more, in spring and summer I go to the country house every day, with my husband we lead an active lifestyle, we travel a lot. Everyone is surprised how I can do everything, where so much strength and energy comes from, they still don’t believe that I’m 66 years old.
Who wants to live a long, energetic life and forget about this terrible disease forever, take 5 minutes and read this article.
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Diabetes rash
Skin rashes in diabetes mellitus (photo 5) take on a varied appearance. Due to metabolic disorders on the skin of the lower leg, round, painless red-brown nodules 5-12 mm in diameter appear.
Acne rash with diabetes mellitus(pictured below) arises from the body's desire to remove excess glucose through the sweat glands of the skin. Reduced immunity contributes to the attachment of bacterial flora - pustules are formed. Diabetic rash occurs in 30-35% of patients.
Usually diabetes mellitus gives complications to the legs. In them, blood circulation is disturbed, this leads to serious consequences. Legs with diabetes(in photo 5) gradually lose sensitivity to temperature, pain and tactile stimuli.
The foot in diabetes mellitus (photo below) suffers from congestion in the venous system, often sends pain signals when walking, and sometimes at rest. But another condition is more dangerous - when a limb, due to the destruction of nerve endings, loses sensitivity and trophic ulcers develop on it. Redness of the leg with diabetes in the form of spots indicates the development of a diabetic foot. This is the late stage of the disease.
Our readers' stories
Defeated diabetes at home. It's been a month since I forgot about the surges in sugar and the intake of insulin. Oh, how I suffered before, constant fainting, ambulance calls ... How many times I went to endocrinologists, but they only repeat one thing - "Take insulin." And now the 5th week has gone, as the blood sugar level is normal, not a single injection of insulin and all thanks to this article. Everyone who has diabetes should read it!
Read the full article >>>Diabetes Nails
Symptoms of diabetes mellitus also appear in the form of deformation of the fingers and nails. Toes in diabetes mellitus (photo below) thicken, deform, red or bluish spots appear on them.
They have a characteristic form nails with diabetes(in photo 6): they become brittle, exfoliate, often grow into the skin with corners. Often the associated fungal infection is to blame. The fragility of the capillaries, especially with tight shoes, leads to hemorrhages under the nail plate, and the nails turn black.
Gangrene in diabetes mellitus
Studying the question what is diabetes mellitus, one cannot ignore its most serious complication - gangrene in diabetes mellitus (in photo 7), which creates a danger to the patient's life. Non-healing wounds on the legs in diabetes mellitus can exist for several years. Their outcome is wet or dry. gangrene of the lower extremities(photo below). With diabetes mellitus, this happens, alas, often with a long-term duration of the disease. Gangrene in diabetes mellitus requires surgery.
Having familiarized yourself in detail with what diabetes mellitus looks like (photo in gal) at all stages, it is easier to assess the danger of its individual symptoms. By revealing signs of diabetes, you must immediately contact a specialist for help. This will make it possible to prevent serious consequences. Diabetes mellitus does not forgive delays in treatment.
Diabetes mellitus pictures and photos (gallery)
Drawing conclusions
If you are reading these lines, we can conclude that you or your loved ones are sick with diabetes.
We conducted an investigation, studied a bunch of materials and, most importantly, tested most of the methods and drugs for diabetes mellitus. The verdict is as follows:
If all drugs were given, then only a temporary result, as soon as the reception was stopped, the disease intensified sharply.
The only drug that gave a significant result is Difort.
At the moment, this is the only drug that can completely cure diabetes mellitus. Difort showed a particularly strong effect in the early stages of the development of diabetes mellitus.
We made a request to the Ministry of Health:
And for the readers of our site now there is an opportunity
get Difort IS FREE!
Attention! Cases of sale of counterfeit drug Difort have become more frequent.
By placing an order using the links above, you are guaranteed to receive a quality product from an official manufacturer. Also, when ordering for official website, you receive a money-back guarantee (including travel costs) if the drug does not have a therapeutic effect.
Diabetes mellitus is a disease belonging to a heterogeneous group. In the WHO definition, diabetes is indicated as a state of chronic hyperglycemia, which can be triggered by many factors, both external origin and genetic factors acting simultaneously. In the pathogenesis, there is an absolute absence of insulin (in the case of type 1 diabetes), or a relative deficiency in the context of resistance to this hormone and impaired insulin secretion (in the case of type 2 diabetes). We are talking about a chronic, incurable disease, the result of which is the development of complications and even pathological changes in organs - typical for diabetes are microvascular (retinopathy, neuropathy, nephropathy) and macrovascular (atherosclerosis, ischemic heart disease, coronary arteries of the lower extremities and the central nervous system) violations.
The clinical course of individual types of diabetes varies greatly, but a common symptom is the presence of hyperglycemia, which has arisen due to insufficient action of insulin in the tissues. Abnormalities also occur in the metabolism of fats, proteins and electrolytes, as well as in the management of the body's water resources.
Skin diseases in diabetes mellitus affect 25-50% of diabetics during their lifetime. The significant differences can be explained by different opinions regarding the assessment of the "specificity" of changes in the skin associated with diabetes, and the differences between different types of disease.
Cutaneous manifestations in diabetes, in terms of their relationship to carbohydrate metabolism, are classified as follows:
- skin changes associated with a violation of carbohydrate metabolism, which occur mainly during metabolic decompensation, and after stabilization of glucose values disappear;
- skin changes not related to the present level of metabolic control (deteriorated skin condition associated with diabetic microangiopathy, macroangiopathy and neuropathy);
- skin changes as a result of diabetes treatment.
Diabetes can affect any part of the body, and the skin is no exception. In diabetes mellitus, the skin (i.e., a change in its condition) is often the first sign of the development of the disease. Many of these problems are common among healthy people, but diabetics develop more easily, for example, itching or fungal and bacterial infections. Other complications characteristic of diabetes are disorders such as diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis.
Bacterial infections
People with diabetes often experience complications such as:
- barley;
- furunculosis;
- folliculitis;
- carbunculosis;
- infections affecting the area around the nail.
Inflamed tissues are predominantly hot to the touch, swollen, painful, and red. The most common cause of these infections is bacteria from the staphylococcus group.
The most common source of fungal infections in diabetics is the attractively named Candida albicans fungus. It promotes itchy rashes - red, moist spots surrounded by small blisters and covered with a crust. The rash usually occurs in the folds of the skin (under the mammary glands, between the toes and hands, armpits, etc.).
Some common fungal infections of diabetics also include, for example, mycoses of the skin, tinea capitis - (a fungal infection of the groin) and vaginal mycosis.
Itching
Localized itching is often caused by diabetes. The cause may be not only a fungal infection, but also dry skin or impaired circulation (causes itching in the lower legs). Often times, applying moisturizers after bathing helps.
Diabetic dermopathy
Diabetes is a disease that causes changes in the network of small blood vessels. The consequences presented by skin lesions are called diabetic dermopathy. Light brown, scaly, oval spots form on the skin, mainly on the front of the legs. Such spots do not hurt, do not itch, and do not require special treatment.
It is a rare condition that, like diabetic dermopathy, is caused by changes in the blood vessels. But the spots are larger, deeper, and appear in smaller numbers. Dark red, raised areas form that eventually develop into glossy scars with purple edges. The subcutaneous blood vessels become more visible. Sometimes itching, soreness or bursting occurs, in such cases it is necessary to see a doctor.
Diabetic blisters
Blisters can occur rarely (for example, in diabetic neuropathy), mainly in the folds of the fingers, hands, or feet. They are similar to burns, but not painful. Usually, they go away on their own without scars, after glycemic compensation.
Eruptive xanthomatosis
This is the idea of another cutaneous manifestation caused by decompensated diabetes. Yellowish, red-edged formations form on the skin, in which fatty substances accumulate. The rash itches. They most often affect people with high levels of cholesterol and blood fats.
Cutaneous manifestations associated with metabolic disorders of connective tissue in patients with diabetes mellitus
Hyperglycemia leads to the binding of glucose to extracellular tissue proteins and fibrillar connective tissue proteins, collagen, elastin, and fibronectin. Changes in the structure affect the functions of various components of connective tissue, degradation disorder leads to their local accumulation. T. n. diabetic hand syndrome includes frequent disorders of the musculoskeletal system.
In addition to structural and functional changes in collagen, vascular changes with gradual ischemia, microangiopathy and neuropathy also contribute to the onset of these symptoms.
- waxy skin syndrome is primarily characteristic of type 1 diabetes, but also occurs in people with type 2 diabetes who are often poorly metabolically compensated. The skin of the fingers and hands thickens, turns pale, a shiny surface appears (as in scleroderma), sometimes it can be compared to a wax coating. Changes are often discrete, often only detected on palpation. The joints are only slightly affected, thickening of the joint capsules occurs with impaired joint mobility, as a rule, due to which the fingers are in a permanent bent state;
- Dupuytren's contracture is an additional medical unit that occurs in the population of patients with diabetes mellitus 2-3 times more often than among the healthy population. This is a painless thickening and shortening of the palmar aponeurosis, which limits the mobility of the fingers. Massage and ultrasound can slow the disorder, more severe forms must be surgically treated;
- Scleredema Buschke affects diabetics 4 times more often than the healthy population, especially obese middle-aged men. It comes to induration of the skin, which occurs most often on the dorsolateral parts of the neck and upper back, sometimes with the presence of erythema. The surface of the skin may have the characteristic orange peel appearance. Effective treatment is not yet known, and diabetes control does not affect the course of the disorder.
- acanthosis psans is clinically manifested by not sharply demarcated areas with intense brown-black pigmentation and coarseness of the skin. Most often, it is localized in the armpits and neck. The disorder is caused by papillomatous hyperplasia of the epidermis and may be associated with hyperinsulinemia and insulin resistance. Along with diabetics, it also occurs in people with other endocrine diseases (acromegaly, Cushing's syndrome, hyperandrogenism);
- Vitiligo is a chronic skin disease of unknown etiology characterized by the loss of melanin in certain areas of the skin. Clinically, the disease manifests itself in light (sometimes even white), sharply delineated round areas, especially on the face, neck, arms and abdomen. The disease is much more common in people with diabetes than in healthy people.
Skin complications of diabetes mellitus treatment
Allergic reactions to insulin injections have all but disappeared with the increased use of the human hormone. Often, however, insulin lipodystrophy occurs, which appears in two clinical variants, such as atrophy or hypertrophy of the subcutaneous tissue. The changes affect the skin and subcutaneous structures. Among the reasons should be noted repeated trauma with daily injections or cannulas of an insulin pump and the local metabolic effects of insulin on adipose tissue.
The skin separates and protects the internal environment of the body from external influences and performs many functions. Undoubtedly, she is a mirror of the human body. Skin reactions can be the first signal of tissue and organ damage, or a sign of certain diseases that have not yet been diagnosed. The main factors that can warn the doctor about the possible occurrence of diabetes mellitus or other diseases are non-healing skin lesions that do not respond to traditional therapy methods, increasing age, obesity, and the prevalence of diabetes in a family history.
Diabetes mellitus is a disease that is often accompanied by skin lesions. In order to prevent skin changes or improve existing manifestations, it is necessary to take regular care of it and adhere to the drinking regime. For washing, it is recommended to use neutral soaps that do not damage the skin, do not cause irritation and do not dry out. Bathing should be replaced with a shower. After washing, it is always appropriate to apply emollient creams. In case of injury, the wound should be rinsed with clean water and covered with a sterile dressing. Products containing iodine, alcohol and peroxide should not be used due to potential skin irritation.
Impaired glucose metabolism in diabetic patients leads to the appearance of pathological changes in all, without exception, organs of the human body. The cause of skin pathology in diabetes mellitus is a high concentration of sugar and the accumulation of toxic products of distorted metabolism. This leads to structural changes not only in the dermis and epidermis, but also in the sebaceous, sweat glands and hair follicles.
Diabetics also have diabetic polyneuropathy and microangiopathy, which also negatively affect the skin. All these factors, as well as a decrease in general and local immunity, lead to the appearance of wounds, ulcers and purulent-septic processes.
Changes in the skin
Due to the disease, the skin of diabetics becomes very dry, rough to the touch, and its turgor decreases. Hair grows dull and falls out more often than usual, since the hair follicle is very sensitive to metabolic disorders. But diffuse baldness speaks of poorly controlled diabetes or the development of complications. For example, hair loss on the lower legs in men may indicate neuropathy in the lower extremities.
The soles and palms are covered with cracks and calluses. Often, the skin becomes unhealthy, yellowish. The nails thicken, deform, and hyperkeratosis of the subungual plate develops.
Often, dermatological symptoms, such as dry and itchy skin and mucous membranes, recurrent skin fungal and bacterial infections, act as a signal of the onset of diabetes.
Classification of skin lesions in diabetes
In modern medicine, about 30 different dermatoses are described that develop against the background of this disease or precede it.
All skin pathologies in diabetics can be divided into 3 large groups:
- Primary - skin lesions that are caused by the direct action of complications of diabetes. Namely, diabetic neuro- and angiopathy and metabolic disorders. Primary pathologies include diabetic xanthomatosis, diabetic dermatopathies, lipoid necrobiosis, diabetic blisters, etc.;
- Secondary are skin diseases caused by bacterial and fungal infections, the frequent relapses of which occur due to diabetes mellitus;
- Dermatoses caused by drugs used in the treatment of diabetes. These include post-injection lipodystrophy, toxidermia, urticaria, eczematous reactions.
Diabetic skin lesions, as a rule, last for a long time, they are characterized by frequent exacerbations. They do not respond well to treatment.
Diabetic Dermatopathy
The most common skin lesion in diabetes mellitus. Angiopathy develops, that is, changes in microcirculation in the blood vessels that feed the skin with blood.
Dermopathy is manifested by the appearance of reddish-brown papules (5–12 mm in diameter) on the anterior surface of the legs. Over time, they merge into oval or rounded atrophic spots, followed by thinning of the skin. This skin lesion is revealed more often in men with a long history of diabetes mellitus.
Symptoms, as a rule, are absent, there is no pain, but sometimes in places of lesions, patients feel itching or burning. There are no treatment methods for dermopathy, it can pass on its own in a year or two.
Lipoid necrobiosis
Chronic dermatosis, which is characterized by fatty degeneration and focal collagen disorganization. The cause of this disease is insulin-dependent diabetes mellitus. Mostly women aged 15 to 40 years old are ill, but necrobiosis lipoidosis can develop in any diabetic.
There is no direct relationship between the severity of the clinical manifestations of this dermatosis and the severity of diabetes.
The cause of this diabetic skin lesion is microangiopathy and secondary necrobiotic changes. If they are present, necrosis of elastic fibers, inflammation with the migration of inflammatory agents to the focus of necrosis is observed. An important role in the pathogenesis of necrobiosis is played by increased platelet aggregation, which, together with the proliferation of the endothelium, leads to thrombosis of small vessels.
Lipoid necrobiosis begins with the appearance on the skin of the leg of small single bluish-pink spots or flat smooth nodules of an oval or irregular shape. These elements tend to grow along the periphery with the further formation of elongated, well-delimited polycyclic or oval inductive-atrophic plaques. The yellowish-brown central part, which sinks slightly, and the cyanotic-red marginal part rises somewhat. The surface of the plaques is smooth, rarely peeling at the periphery.
Over time, the central part of the plaques atrophies, spider veins (telangiectasias), slight hyperpigmentation, and in some cases ulceration areas appear on it. In most cases, there are no subjective sensations. During the period of the appearance of ulcers, pain occurs.
The picture of skin lesions in necrobiosis lipoid is so characteristic that basically there is no need for additional research. Differential diagnosis is carried out only in atypical forms with sarcoidosis, annular granuloma, xanthomatosis.
Scientists believe that in 1/5 of diabetics, necrobiosis lipoidosis can appear 1-10 years before the development of specific symptoms of diabetes.
Treatment of necrobiosis lipoid
There is no effective treatment for necrobiosis lipoidosis. We recommend drugs that normalize lipid metabolism and improve microcirculation. Vitamins and multivitamin complexes are also prescribed. Intrafocal injections of heparin, insulin, and corticosteroids are successfully used.
Outwardly shown:
- applications with Dimexide solution (25–30%);
- troxevasinic, heparin ointments;
- dressings with corticosteroid ointments.
Physiotherapy. Phono - or electrophoresis with hydrocortisone, aevit, trental. Laser therapy, rarely ulceration is removed by surgery.
Itchy dermatoses
This pathology is also called neurodermatitis, it is manifested by itching of the skin. Very often, neurodermatitis becomes the first symptom of diabetes. Localization mainly of the folds of the abdomen, limbs, genital area.
There is no direct relationship between the intensity of itching and the severity of diabetes. However, it has been noticed: the most persistent and severe itching is observed with "mute" (latent) and mild diabetes mellitus. Neurodermatitis can also develop against the background of inadequate blood sugar control with established diabetes.
Fungal skin diseases in diabetics
Most often, candidiasis develops, the causative agent of Candida albicans. Recurrent candidiasis is one of the first symptoms of diabetes mellitus.
It occurs mainly in the elderly and in obese patients. It is localized mainly in the genital area and large folds of the skin, as well as on the mucous membranes, in the interdigital folds. With any localization of candidiasis, its first sign is persistent and severe itching, then other objective symptoms of the disease join it.
At first, a whitish strip of macerated epidermis appears in the depths of the fold, surface erosion and cracks are formed. Erosions have a shiny and moist surface, the defect itself is bluish-red and limited by a white rim. The main focus of candidiasis is surrounded by small superficial pustules and vesicles, which are its droplets. These elements of the rash open up and become erosions, thus, the area of the erosive surface increases. The diagnosis can be easily confirmed by culture and microscopic examination.
Treatment of candidiasis in diabetes
Therapy should be comprehensive and include:
- antimycotic ointments or creams that need to be applied until the rash disappears, and then another 7 days;
- solutions of aniline dyes, they can be alcoholic or aqueous (with a large lesion area). These include - 1% brilliant green solution, 2-3% methylene blue solution. Also, for local treatment, Castellani liquid and 10% boric acid ointment are used;
- systemic antifungal agents fluconazole, ketoconazole, itraconazole. The common sense of prescribing these drugs is that they are quite effective, affordable, and thanks to them, you can quickly get rid of the symptoms of candidiasis.
Bacterial skin diseases in diabetics
The most common skin ailments in diabetes mellitus. The difficulty is that they are difficult to treat and lead to life-threatening complications such as sepsis or gangrene. Infected diabetic foot ulcers can lead to leg amputation or death if not treated promptly.
Diabetics are much more likely than the rest of the population to have boils, carbuncles, pyoderma, phlegmon, erysipelas, paronychia and panaritium. They are usually caused by streptococci and staphylococci. The addition of infectious and inflammatory skin diseases leads to prolonged and severe exacerbations of diabetes and requires the appointment or an increase in the dose of insulin.
Therapy of these diseases should be based on the results of studies of the type of pathogen and its sensitivity to antibiotics. The patient is prescribed tablet forms of broad-spectrum antibiotics. If necessary, surgical procedures are performed, for example, opening a boil, draining an abscess, etc.
Diabetic dermatoses such as diabetic bullae, rubeosis, acanthokeratoderma, diabetic scleroderma, diabetic xanthoma, disseminated annular granuloma are very rare.
Skin lesions in diabetics are quite common today. Treating these conditions is challenging. It should begin with successful blood sugar control and selection of an adequate combination of diabetes medications. Without correction of carbohydrate metabolism in this group of patients, all methods of treatment are ineffective.
Diabetes mellitus today is one of the most common diseases that can have dangerous complications. It is imperative for diabetic patients to be aware of the potential skin problems associated with the disease, and it is important to consult a doctor before these problems get out of control. In most cases, skin changes in diabetes mellitus, provided that they are diagnosed early and treatment started on time, are reversible, or they can be completely avoided .. the most common skin changes in diabetes mellitus.
The most common skin pathologies in diabetes mellitus
In the event of damage to the skin in places where atherosclerosis progresses, the healing process lasts much longer than on healthy skin, which is associated with a violation of trophism.
Skin pathologies in diabetes mellitus include the following changes:
- diabetic lipodystrophy;
- diabetic dermopathy;
- sclerodactyly;
- eruption xanthomatosis;
- diabetic pemphigus;
- disseminated annular granuloma.
Pathological conditions of the skin in diabetes mellitus
Diabetic lipodystrophy occurs at the sites of constant administration of insulin, therefore it is important to know the possible zones and frequency of changes in the localization of injections. Sometimes the site of lipodystrophy of the skin in diabetes mellitus may itch or hurt, possibly ulceration of the surface.
Diabetic dermopathy is a change in the blood vessels that supply blood to the skin. Dermopathy is manifested by round or oval lesions with thinned skin, which are localized on the anterior surfaces of the legs. The spots are painless and may be itchy or burning.
Sclerodactyly is a complication of diabetes mellitus, in which the skin on the fingers and toes thickens, becomes waxy and tight, the mobility of the interphalangeal joints is impaired, and it becomes difficult to straighten the fingers. The changes are irreversible.
Bulging xanthomatosis occurs in the form of a dense, waxy, pea-shaped yellow plaque on the surface of the skin in diabetes mellitus, which is provoked by an increase in the level of triglycerides in the blood. The plaques are itchy, often surrounded by a red halo, and are typically located on the face or buttocks, as well as on the back of the arms and legs, especially on the bends of the limbs.
Diabetic pemphigus or diabetic bullae present with changes similar to blisters from burns. Blisters can occur on fingers, hands, feet, feet, legs, and forearms. Diabetic pemphigus is not accompanied by painful sensations and goes away on its own.
Disseminated annular granuloma is represented by a clearly limited annular or arcuate skin area. Elements of a granuloma rash on the skin in diabetes mellitus more often appear on the fingers and ears, and can also occur on the chest and abdomen. The rashes are red, reddish-brown, or flesh-colored.
Skin lesions in diabetes mellitus caused by insulin resistance
Acanthokeratoderma is manifested by darkening and thickening of the skin in certain areas of the body, especially in the area of skin folds. Skin with diabetes mellitus becomes hard, rough, turns brown, and sometimes there are elevations on it, described as corduroy.
Most often, changes in acanthoderma, which are mistakenly perceived as papillomas on the skin, occur on the lateral or back surface of the neck, in the armpits, under the breast and in the groin. Sometimes changes occur in the skin of the fingertips.
Acanthokeratoderma usually precedes diabetes mellitus, and therefore is considered a marker. It is important to remember that some other diseases can also be accompanied or cause skin acanthosis (acromegaly, Itsenko-Cushing's syndrome). It is believed that it is acanthokeratoderma that is the cutaneous manifestation of insulin resistance.
Thus, when detecting skin changes in diabetes mellitus, it is necessary to contact an endocrinologist in order to correct the treatment or additional control of the underlying disease.
The skin is one of the first organs to respond to changes in carbohydrate metabolism. Due to a decrease in local immunity and the accumulation of metabolic products in the skin, the risk of developing various diseases increases. Most skin diseases are manifested by rashes.
The skin is one of the first to react to a persistent increase in glucose in the circulating blood or hyperglycemia. Violation of carbohydrate metabolism leads to the appearance and accumulation of atypical metabolic products that disrupt the activity of sweat and sebaceous glands. Changes in the small vessels of the skin, polyangiopathy and disturbances in the nervous regulation of vascular tone are combined in diabetes mellitus with problems of the immune system, both general and local. All these factors lead to the appearance of various skin diseases, itching, scratching and infection.
Skin changes
The photo shows the state of the epidermis in diabetes mellitus. Normal skin has a high turgor - elasticity. This is due to the normal water content in the cells. In diabetics, due to the fact that fluid is not retained in the body and is excreted with sweat and urine at an increased rate, the skin tissue loses its elasticity, becomes dry and rough, and this is felt when touched.
As the disease progresses, changes become pronounced. Persistent itching of the skin, persistent, profuse peeling appears. The epidermis becomes thinner, peels off in whole plates, this is well shown in the photo. It is especially noticeable on the scalp, where peeling, itching are accompanied by increased hair loss, dullness, dryness.
On the rest of the skin, spots of various sizes, color, and rashes may appear, which may be accompanied by severe itching. The areas of the skin that are subject to friction are the soles and palms of the hands become callous, the skin becomes rough, and can acquire a persistent yellow coloration. Any minor wound becomes problematic and does not heal for a long time.
A characteristic combination in diabetes mellitus is thinning of the skin with simultaneous hyperkeratosis (thickening) of the nail plates. Nails become thicker several times, turn yellow, change their shape - deform. How exactly it looks is shown in the photo.
So, it can be argued that with diabetes mellitus, the skin undergoes the following changes:
- becomes dry, rough;
- thinning;
- nail hyperkeratosis develops - the proliferation of nail plates;
- areas of calcification appear on the soles, palms;
- yellowing of the skin is observed.
However, all these problems become persistent over time. There are the most characteristic cutaneous manifestations by which one can suspect or observe the effectiveness of treatment in diabetes mellitus.
Skin diseases in diabetes
One of the signaling signs of the disease in diabetes mellitus is skin itching. He acquires a stubborn character, gives the patient significant difficulties, inconveniences in everyday life. The patient scratches the itchy areas: the anterior surface of the lower leg, groin area, thereby causing multiple damage to the epidermis (see photo). Such microcracks, scratches do not respond well to treatment, often become infected, and take a chronic course.
All skin diseases that appear in diabetes mellitus can be divided into several large groups.
- Associated with changes in blood vessels, metabolic metabolic disorders. These are the so-called primary skin diseases in diabetes.
- Skin infections: fungal and bacterial, which occur as secondary complications of damage to the epidermis.
- All other diseases that are provoked by therapeutic drugs and procedures during the treatment of the underlying disease.
Primary diseases
Dermatopathy
This includes diabetic dermatopathy. Diabetes occurs very often. Spots appear on the front surfaces of the shins. Painted in an intense reddish brown color, significantly different from the rest of the skin. The spots have a well-defined border, the color over time and the duration of the disease becomes steadily brown, and the structure of the altered skin area itself changes.
This is due to changes in blood vessels in this area (shown in the photo). No special treatment is applied in this case. The condition is corrected by constantly maintaining blood sugar levels within normal limits.
Lipoid necrobiosis
It is rare compared to other dermatoses in diabetes. The severity or nature of the development of the rash does not directly depend on the level of sugar in the blood. More often occurs in people with type 1 diabetes - insulin-dependent.
It is characterized by the appearance of pinkish spots not raised above the rest of the skin level, which have an elongated or rounded shape. In the center, the spots sink slightly, closer to the edge - they are raised, this is shown in the photo. Gradually, the central part of the spot atrophies, turns brown, and ulcerative lesions can form.
These rashes are located on the front of the lower leg. There are no subjective painful sensations (itching, pain, peeling) until the formation of ulcerative changes.
Treatment is based on drugs that normalize lipid metabolism (these include, for example, Lipostabil) and drugs that normalize and improve the microcirculatory processes of the skin (Trental, Curantil).
Treatment with the introduction of corticosteroid drugs directly into the lesion site, compresses and applicative dressings with Dimexide solution is indicated. With the active development of ulcerative changes, surgical treatment using laser technology is possible.
Itching of the skin in diabetes mellitus is the most characteristic, or as it is also called, a signaling sign. A characteristic feature of this symptom is the absence of a direct correlation with blood glucose levels and the intensity of itching and rashes. On the contrary, with the development of diabetes mellitus, the urgency of itching fades into the background, its greatest intensity is noted by patients at the onset of the disease.
Secondary complications
Active combing, persistent trauma to the skin with a simultaneous decrease in immunity, both general and local, sooner or later leads to the fact that small lesions and wounds on the skin become infected with various microorganisms. Most often these are causative agents of fungal diseases. The fact is that it is fungal microorganisms that actively multiply under conditions of a shift in the pH of human skin in diabetes. Ideal conditions are created for them:
- violation of the pH of the skin;
- proliferation of epithelial plates - desquamation, hyperkeratosis;
- profuse sweating leads to maceration - abrasions and diaper rash of the skin.
Fungal diseases in diabetes mellitus increase itching, respond poorly to treatment, leave spots of persistent pigmentation behind, rashes tend to grow and merge with each other, the photo shows candidiasis of the skin.
Treatment involves topical treatment with antifungal ointments, aniline dyes (brilliant green, Castellani). In some cases, the doctor prescribes antimycotic drugs for oral administration.
Skin rash infections are much more common in people with diabetes than in people who do not. Itching leads to infection and serious complications. These include erysipelas, phlegmon, boils, carbuncles, paronychia and panaritium.
Conclusion
Successful treatment of skin diseases in patients with diabetes mellitus directly depends on the success of the treatment of the underlying disease, the patient's discipline while following the recommendations for correcting blood sugar and monitoring its level. Without these conditions, effective treatment of skin rashes and diseases in diabetics is very difficult.
