Diabetes and your skin
As we know, diabetes affects all aspects of your body; including your skin. In fact, according to the ADA 1/3 of PQD have a skin condition caused or affected by the disease in their lifetime.
The most common skin conditions in DM are bacterial (staph) and fungal (candida) infections. These infections can become quite serious if not recognized or treated appropriately. Bacterial infections can present in many ways; styes, boils, foliculities (infection of hair follicle), nail infections, and infection of a cut or laceration. They are typically treated with antibiotics (topical or oral). It is essential to catch infections early to prevent spread of the infection to the blood (sepsis) or bone (osteomyelitis).
Symptoms of skin infections include redness, swelling, itching, blisters, skin discoloration, pain, pus, or fever. Uncontrolled BGs make PWD more prone to infections because of the decreased healing time associated with frequent BG fluctuations. The more time a cut takes to heal, the higher the chance of bacteria infecting the cut. This is also true for surgery and is why elective surgery is often delayed until HbA1c levels can be improved.
Fungal infections are itchy, red, moist, and sometimes scaly and most frequently occur in moist dark places (between the toes, skin folds, and groin). Vaginal yeast infections are one of the most common infections occurring in women with DM. All fungal infections can be treated with oral or topical antifungals.
Now let’s talk about skin conditions specific to DM…
Acanthosis Nigricans occurs more frequently in people with type 2 diabetes who are overweight. They are brown/tan raised areas most commonly located on the sides and back of the neck, armpits, and groin. The best treatment for these is weight loss, but there are also some creams that can help.
Diabetic dermopathy is VERY common and presents as circular/oval brown scaly spots most regularly seen on the lower extremities. This is caused by changes in the small blood vessels beneath the skin. They are often confused with age spots, do not hurt/itch, and are harmless.
Necrobiosis Liopidica Diabeticorum is very rare, but also caused by changes in the blood vessels. It presents similarly to diabetic dermopathy except that the spots are larger and deeper. Sometimes the spots caused by NLD are painful and itchy and they can crack open. If this occurs, treatment is necessary due to risk of infection.
Below are my legs. Yes…I know they’re ugly (and they’re my biggest insecurity, so be nice). I have a genetic skin disease called epidermolysis bullosa which in short is a very rare skin condition which causes blisters with injury to the epidermis (top layer of the skin). It is not caused by diabetes. My mom has it too. When formed, these blisters are very fragile and often break open. This is further complicated by my diabetes due to my increased risk of infection. I must be diligent about keeping these areas clean and am constantly following up with my dermatologist if there are any signs of infection.
I hope that this post inspires you to stay diligent regarding your skin care and your follow up. Remember, this list of conditions is by no means thorough. There are many other rare and serious skin conditions associated with the disease. Follow up with your clinician with questions.