Skin Problems with Diabetes – Part 1

If you have diabetes, potentially serious skin problems can be part of your life also. See your doctor as soon as you notice a problem and before it gets out of control. In most cases, these skin problems can be managed with early diagnosis and treatment.

WebMD lists the following:

1. Some Skin Problems Linked to Diabetes,
   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 sugar 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 an SPF of 30 or higher to prevent sunburn on the discolored skin. 
   
   
2. 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 small warts, 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. 
   
   
3. 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. Lesions have fairly well defined borders between them and normal skin. 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 sugar level under control. Lotions and moisturizers may help soften the skin.
   Eruptive xanthomatosis: This skin condition may occur when blood sugar 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.