diabetes is an endocrine pathology It has effects on almost the entire body. It can produce various types of skin lesions, many of them accompanied by a rash, with a prevalence of around 33%.
Many of these conditions can occur in anyone, for example bacterial infections, but diabetics are more prone. Others, on the contrary, are specifically associated with diabetes, such as diabetic dermopathy or eruptive xanthomatosis.
The skin is the largest organ in the body and among its many functions, its role as part of the immune system stands out, protecting us from external agents. Diabetic patients who do not maintain glycemic control are more prone to skin infections as high glucose levels favor bacterial and fungal growth.
One of the most common bacterial skin infections is that caused by staphylococcus, especially Staphylococcus aureus (Staphylococcus aureus). These bacteria normally live on the skin without causing damage, but their growth is accelerated when glucose levels are high. It is common in hair follicle infections, infections around the nails and in styes.
Of fungal infections, cutaneous candidiasis is usually produced by the species Candida albicans. This yeast is common in the intestinal flora, in the mouth, in the vagina and in moist areas of the skin such as the groin, armpits or under the breasts. Diabetic patients are also more prone to other fungal infections such as ringworm, itchy groin and athlete’s foot.
Specific skin conditions
Some skin conditions are typical of diabetes and do not occur in other people or occur in rare cases. Some of them have an autoimmune component and only occur in type 1 diabetes.
A common symptom in diabetes is thickening of the dermis, easily seen on the palms and feet, dorsum of fingers, chest, and back of neck. In patients with prolonged poor glycemic control, it is also common for the skin to appear yellowish, probably due to advanced glycosylation products.
scleredema is an advanced stage of skin thickening; It is common for the skin on the chest and back of the neck to become hard and rough, like the skin of an orange. Scleredema affects 2.5% of elderly patients with type 2 diabetes and is more common in women.
The changes that diabetes produces in the capillaries and small blood vessels of the skin produce what is known as diabetic dermopathy. It is characterized by reddish spots They can reach 2 cm in diameter. If blood glucose is not controlled, they can evolve to form dark crusts. In principle, this symptom is not dangerous and does not require specific treatment.
Eruptive xanthomatosis is the most common type of xanthomas and is due to a lipid disorder caused by an increase in chylomicrons that can be associated with diabetes. Rashes appear as painless papules, usually grouped in clusters, which tend to disappear when blood glucose is controlled.
Necrobiosis lipoidica is characterized by the appearance of red rashes with yellowish edges. Although slow growing, they can join together and form larger plaques. In addition to diabetes, it has also been observed in patients with impaired glucose resistance due to other causes.
It is rare, affects only 0.3% of diabetics, and its exact cause is not known, although it is believed that it may be related to microcirculation alterations, collagen abnormalities or immunological mechanisms.
Diabetic blisters are rare. They are similar to burn blisters and usually appear suddenly for no apparent reason. In many cases, they disappear without treatment.
Many of the patients who develop diabetic blisters have other symptoms such as peripheral neuropathy, retinopathy, and nephropathy, typical of an advanced stage of diabetes.
It is a rash produced by circular, ring-shaped tumors that appear mainly on the fingers, eyelids, abdomen, chest, and legs, although it can spread throughout the body.