Cutaneous manifestations of diabetes

Abstract

Diabetes mellitus is a heterogenous group of metabolic disorders characterized by elevated serum glucose levels resulting from defects in insulin production, insulin action, or a combination. Complications include retinopathy, nephropathy, and neuropathy. The two main types of diabetes are Type1 insulin-dependent diabetes mellitus characterized by the destruction of insulin-producing beta cells of the pancreas creating the absolute need for exogenous insulin and Type2 non-insulin-dependent mellitus associated with an older age, obesity, physical inactivity, and family history. Type2 diabetes is increasingly being diagnosed in children and adolescents. Diabetes has been implicated as the single largest cause of end-stage renal disease, the main reason for non-traumatic amputation, and an independent risk factor for cardiovascular disease [1]. Nearly one-third of diabetic patients have some type of dermatologic manifestation. With time, the skin of all diabetic patients is affected in some form or another. Cutaneous signs of diabetes mellitus are extremely valuable to the clinician. For example, diabetic bullae, diabetic dermopathy, necrobiosis lipoidica diabeticorum, and the scleroderma-like syndrome of waxy skin with limited joint mobility can alert the physician to the diagnosis of diabetes [2,3]. Eruptive xanthomas reflect the status of glucose and lipid metabolism. This review will focus on the clinical features, the pathogenesis, and treatment strategies of the cutaneous manifestations of diabetes. © Springer-Verlag London Limited 2008.