• The skin is the largest organ of the body and individuals with diabetes are at an increased risk of skin complications. Some of these include:
Diabetic Dermopathy
  • Also known as shin spots, these are spots or lines which usually appear around the shins and more rarely in other parts of the body
  • They do not hurt, but in some cases may be itchy. They usually disappear over time and with better blood sugar control.
    *Image from American Association of Dermatology
Diabetic Scleroderma/ Scleroderma diabeticorum
  • Diabetic scleroderma is usually described as the thickening of skin of just the upper back. Digital sclerosis, the hardening and thickening of the skin of the fingers and/or toes may also occur
    •  In this condition, the skin is said to have the texture of an orange peel
    • This hardening is linked to control of the blood sugars and affected individuals may see improvement with better blood sugar control
    • Type 1 Diabetes is also associated with systemic scleroderma
    *Image from Taber’s Online
 
Dry Skin
  • Dry skin is a common complaint among individuals with diabetes.
  • Careful management with good lotion is important as cracks (especially in in the heels and feet) can occur. These cracks can allow bacteria to enter and infection to occur. It is especially important to check regions such as between the toes for cracks
    *Image from Blackdoctor.org
 
Fungal and Bacterial infections
  • Fungal infections are especially common when blood glucose is not controlled. Common sites of yeast infections are mouth, nails, genitals, feet, and skin folds
  • It is important to understand that high blood sugars act to dampen the immune and act as a fuel for fungal infections
  • The most common fungal infections are Candida or Yeast infections
  • Bacterial infections can occur in the same regions as fungal infections. They may also manifest as boils or inflammation around the hair roots
Vitiligo
  • Vitiligo is a condition in which patches of the skin’s pigment cells (melanocytes) are destroyed. This disease is more closely linked to Type 1 Diabetes that Type 2.
Acanthosis Nigricans
  • A condition where skin darkens/discolors, thickens, and becomes velvet-like in texture primarily around skin folds. Common regions effected include the neck and armpits. Acanthosis nigricans is associated with insulin resistance and obesity. Studies in Trinidad have considered using acanthosis nigricans as a screening tool for Type 2 Diabetes.
Useful References
  • Acanthosis screening in the Caribbean - https://dmsjournal.biomedcentral.com/articles/10.1186/1758- 5996-6- 77
  • American Academy of Dermatology - https://www.aad.org/public/diseases/other-conditions/diabetes- warning-signs

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