A Guide To Cutaneous Manifestations Of Diabetes

By Jared Wilkinson, DPM, Michael Palladino, DPM, and Peter Blume, DPM

      As the diabetic population continues to swell worldwide, there has also been an increased occurrence of various cutaneous manifestations associated with the disease. Researchers have reported a greater than 30 percent incidence of these disorders and they have been found in up to 70 percent of all patients with diabetes at some point during the course of their illness.1-5 Another problematic statistic for the diabetic population is the fact that 15 percent of all people with diabetes will experience at least one ulceration during their lifetime.6       Although those with type 1 diabetes are more highly associated with developing autoimmune type cutaneous lesions, non-insulin dependent diabetic patients can also be afflicted by these lesions.7,8 One common cause of these cutaneous lesions appears to be poor glycemic control. Other typical findings associated with uncontrolled diabetes that contribute to the various cutaneous manifestations include neuropathy, immunopathy, angiopathy and nephropathy among others. While insulin-dependent diabetic patients are more predisposed to these cutaneous lesions, patients with type 2 are at an increased risk to develop skin infections, which one may see in 50 percent of these patients.9,10       Accordingly, let us take a closer look at the more common diabetic cutaneous afflictions and their proposed etiologies. Diabetic ulcerations and various associated infections have been covered in depth in previous articles in this publication. Therefore, we will direct our focus toward the more autoimmune cutaneous presentations.

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