Skin Problems
Skin Problems in Diabetes
If you have diabetes, it’s important to be aware of potentially serious skin problems related to diabetes and see your doctor before the problem gets out of control. In most cases, skin problems in diabetes can be managed with early diagnosis and treatment.
Diabetes Skin Problems
- Scleroderma diabeticorum: While rare, this skin problem affects people with type 2 diabetes, causing a thickening of the skin on the back of the neck and upper back. The treatment is to bring your blood glucose level under control. Lotions and moisturizers may help soften skin.
- Vitiligo: Vitiligo, a skin problem more commonly associated with type 1 diabetes than type 2 diabetes, affects skin coloration. With vitiligo, the special cells that make pigment (the substance that controls skin color) are destroyed, resulting in patches of discolored skin. Vitiligo often affects the chest and abdomen, but may be found on the face around the mouth, nostrils and eyes. Current treatment options for vitiligo include topical steroids and micropigmentation (tattooing). If you have vitiligo, you should use sunscreen with a SPF of 15 or higher to prevent sunburn on the discolored skin.
Skin Problems Linked to Diabetes and Insulin Resistance
- Acanthosis nigricans. This is a skin problem that results in the darkening and thickening of certain areas of the skin especially in the skin folds. The skin becomes tan or brown and is sometimes slightly raised and described as velvety. Most often the condition, which typically looks like a small wart, appears on the sides or back of the neck, the armpits, under the breast, and groin. Occasionally the top of the knuckles will have a particularly unusual appearance. Acanthosis nigricans usually strikes people who are very overweight. While there is no cure for acanthosis nigricans, losing weight may improve the skin condition. Acanthosis nigricans usually precedes diabetes and is considered to be a marker for the disease. There are other health conditions that also are known to cause acanthosis of the skin and these include acromegaly and Cushing syndromes. It is thought that this health condition is a skin manifestation of insulin resistance.
Skin Problems Associated With Reduced Blood Supply to the Skin
- Skin problems linked to atherosclerosis: Atherosclerosis is a serious health condition caused by the narrowing of blood vessels from a thickening of the vessel walls due to plaque buildup. While atherosclerosis most often is associated with blood vessels in or near the heart, it can affect blood vessels throughout the body, including those that supply blood to the skin. When the blood vessels supplying the skin become narrow, changes occur to the skin due to a lack of oxygen, such as hair loss, thinning and shiny skin especially on the shins, thickened and discolored toenails and cold skin. Because blood carries the white blood cells that help fight infection, legs and feet affected by atherosclerosis heal more slowly when they are injured.
- Necrobiosis Lipoidica Diabeticorum: Necrobiosis lipoidica diabeticorum (NLD) is thought to be caused by changes in the collagen and fat content underneath the skin. The overlaying skin area becomes thinned and reddened. Most lesions are found on the lower parts of the legs and can ulcerate if subjected to trauma. Lesion have fairly well defined borders between normal skin and affected lesions Sometimes, NLD is itchy and painful. As long as the sores do not break open, treatment is not necessary. If the sores do break open, see your doctor for medical treatment.
- Diabetic Dermopathy: Also called shin spots this skin condition develops as a result of changes to the blood vessels that supply the skin. Dermopathy appears as a shiny round or oval lesion of thin skin over the front lower parts of the lower legs. The patches do not hurt, although rarely they can be itchy or cause burning. Medical treatment generally is not necessary.
- Digital Sclerosis: Digital sclerosis is a health condition in which the skin on your toes, fingers and hands become thick, waxy and tight. Stiffness of the finger joints also may occur. The medical treatment is to bring your blood glucose level under control. Lotions and moisturizers may help soften the skin.
- Eruptive Xanthomatosis: This skin condition may occur when blood glucose levels are not well controlled and when triglycerides rise to extremely high levels. Severe resistance to insulin makes it difficult for the body to clear the fat from the blood. With extreme elevations in these blood fats people are at risk for pancreatitis, an inflammation of the pancreas. Eruptive xanthomas appear as firm, yellow, waxy pea-like bumps on the skin. The bumps -- which are surrounded by red halos and are itchy -- usually are found on the face and buttocks. They also can be seen on the back side of the arms and legs as well as in the creases of the extremities. Treatment for eruptive xanthomatosis consists of controlling the level of fats in your blood. The skin eruptions will resolve over a few weeks. Drugs that control different types of fats in the blood (lipid-lowering drugs) may also be needed.
Rashes, Bumps, and Blisters
- Rashes and bumps: Allergic reactions to foods, bug bites and medicines can cause rashes, depressions or bumps on the skin. It is especially important for people with diabetes to check for skin problems, such as rashes or bumps, in the areas where they inject their insulin.
- Diabetic blisters (bullosis diabeticorum): In rare cases, people with diabetes develop skin problems, such as blisters that resemble burn blisters. These blisters can occur on the fingers, hands, toes, feet, legs or forearms. Diabetic blisters usually are painless and heal on their own. These skin problems often occur in people who have severe diabetes and diabetic neuropathy. Bringing your blood glucose level under control is the medical treatment for this health condition.
- Disseminated granuloma annulare: This skin condition causes sharply defined, ring or arc-shaped areas on the skin. These rashes most often occur on the fingers and ears, but they can occur on the chest and abdomen. The rash can be red, red-brown or skin colored. Medical treatment usually is not required, but some times a topical steroid medication, such as hydrocortisone, may help.
Bacterial and Fungus Infections
- Bacterial Infections: There are different kinds of bacterial infections affecting the skin. Skin problems infections with the bacteria known as Staphylococcus are more common and more serious in people with diabetes which is not under control. These bacteria can result in 'boils', an inflamed nodule from a hair follicle, which can occur in areas where hair follicles can be irritated. Other infections include styes, which are infections of the glands of the eyelids, and bacterial nail infections. Most bacterial infections require medical treatment with antibiotics in the form of pills and/or creams.
- Fungal Infections: A yeast-like fungus called "Candida albicans" is responsible for many of the fungal infections causing skin problems in people with diabetes. Women in particular are prone to infection with this fungus in the vagina. Other commonly seen areas of infection include the corners of the mouth with what is known as "angular cheilitis," which feels like small cuts on the corners of the mouth. Fungus also can occur in between the toes and fingers and in the nails (onychomycosis). This fungus creates itchy, bright red rashes, often surrounded by tiny blisters and scales. These infections most often occur in warm, moist folds of the skin. Three common fungal infections are: jock itch (red, itchy area on the genitals and the inside of the thighs), athlete's foot (affects the skin between the toes), and ringworm (ring-shaped, scaly patches that can itch or blister and appear on the feet, groin, chest and abdomen, scalp or nails). Medicines that kill the fungus are usually needed to treat these infections. A potentially fatal fungal infection with Mucormycosis is seen in people with diabetes. The infection usually starts in the nasal cavities and can spread to the eyes and brain.
Cardiovascular disorders and therapies are often associated with a variety of dermatologic manifestations. Frequently, these cutaneous signs can be used in facilitating a diagnosis of the underlying cardiac disease. For example, the diagnosis of acute rheumatic fever in patients presenting with acute carditis includes two skin signs out of the five classic Jones criteria (i.e., arthritis, carditis, erythema marginatum, subcutaneous nodules, and chorea). Certain congenital cardiac defects are associated with unique skin manifestations, such as coarctation of the aorta associated with external features of Turner syndrome or atrioventricular (AV) septal defects associated with skin features of Down syndrome. In some patients, the dermatologic manifestations represent a component of a full systemic or vascular disorder that also involves defects in the cardiovascular system as another accompanying component.
Advanced medical and invasive therapies have led to recognition of many new dermatologic manifestations, for example, angioedema from ACE inhibitors, ankle swelling due to calcium channel blockers, or radiation skin burns following prolonged angioplasty and radiation exposure. Calcium channel blockers and ACE inhibitors have also been reported to cause drug-induced cutaneous lupus erythematosus.
Menopause can cause a problem with a woman’s skin. Just they thought the acne breakouts from the teenage years were over, they find themselves faced with it again. Instead of having beautiful, smooth skin, they might find themselves faced with dry skin, acne breakouts, or other problems! Unfortunately, menopause and skin problems go hand-in-hand. Therefore, the closer to mid to late forties they get, the more they will start to notice changes in their bodies.
Dermatology Risk Factors
Skin problems often can turn out to be life threatening. A little negligence or late treatment of various skin problems can cause skin cancer. Serious diseases associated with diabetes cause severe damage to the skin. Being the most vulnerable organ, open to all types of pollution and other damages, skin suffers from high risk of easy infection and fast spreading of all diseases. Even problems like dry skin can cause much trouble if not treated in time.
There are several types of dermatological diseases, which may affect your skin in different ways. One of the most obvious results will be multiplying of symptoms. Skin diseases spread quite fast. If early measures of treatment are not taken in time, your skin can be covered with bad patches. What more irritated skin can make leading life a problem, with strict restrictions on the usage of water, soap, crème, body talc and even clothes.
Skin works as the reflection of the hale and hearty lifestyle, the absence of disease and healthy body. Tainted skin denotes the presence of underneath diseases and unhealthy lifestyle, damaging the appearance and beauty of a person, and thus diminishing the self esteem and self confidence to a great extent.
Next Steps:
Poor health can significantly affect your life. Improve your life by changing to good health. Call our patient coordinator at 1-212-679-9667 or click on Request an Appointment to schedule an appointment with one of our doctors for evaluation and testing.
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Article Last Updated: 06/26/2009