What Is Diabetic Dermopathy?

Diabetic skin disease is a collective term for the specific skin manifestations of diabetes. Its incidence is positively correlated with the duration and severity of diabetes. Almost all patients with diabetes have related skin lesions, but they are more common in elderly patients. Because diabetes is a systemic metabolic disease, diabetic skin diseases have diverse manifestations and can have a significant impact on the quality of life of patients, which should be taken seriously.

Basic Information

Visiting department

dermatology

Multiple groups

Elderly diabetic

Common causes

Disturbances in immune regulation, elevated blood glucose levels, etc.

Common symptoms

Diabetic infection, diabetic skin disease, diabetic bullae, diabetic skin thickening, diabetic nail disease, diabetic foot

Causes of diabetic skin disease

Diabetic skin disease is a specific skin manifestation of diabetes. Disorders of immune regulation and elevated blood sugar levels in diabetic patients are conducive to the reproduction of pathogens. Diabetic neuropathy makes the skin susceptible to damage and difficult to heal. The pathogenesis of this disease is unknown. It may be due to the deposition of glycoproteins on the capillary basement membrane of diabetic patients, thickening of the tube wall and tissue hypoxia, causing multi-factorial pathological processes, mainly microvascular lesions.

Clinical manifestations of diabetic skin disease

1. Diabetic infection Diabetic patients have a high risk of infection. Skin, soft tissue and bone are the most common sites of diabetic infection. Streptococcus, Staphylococcus aureus, Gram-negative bacilli and anaerobic bacteria are the most common bacterial infections. Viruses The infections were mainly shingles and herpes simplex; fungal infections were mainly Candida albicans. The most common skin diseases are candida eczema, balanitis, vaginitis, paronychia, onychomycosis.
2. Diabetic dermatosis This disease is the most common skin manifestation in diabetic patients, also known as diabetic anterior tibial plaque. It is more common in males and occurs in the tibialis anterior, forearm, femoral, and bone carinae. The skin lesions are initially 0.5 to 1 cm round or oval dark red papules, which develop slowly, and can fade in 1 to 2 years. Remaining atrophic pigmentation or hypopigmentation spots can persist and persist for a long time. Patients were mostly without symptoms.
3. Diabetic bullous skin lesions occur in the distal extremities, especially in the feet and lower legs. They appear as sudden blisters and bullae, ranging from several millimeters to several centimeters in diameter. Redness, self-healing in 2 to 5 weeks, leaving no scars, easy to relapse. Patients were mostly without symptoms.
4. Diabetic skin thickening is commonly found in diabetic stiff joints, also known as hand joint disease. The connective tissue around the joints and the skin are thickened and tight, which leads to limited joint movement. The disease usually begins at the distal fingertip joint of the fifth finger and gradually progresses to the proximal end. At last, it can involve all knuckles, and large joints such as elbows, knees, and ankles can also be affected.
5. Diabetic A disease This disease is often caused by a bacterial or fungal infection. Bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus, or E. coli can cause acute inflammation of the nail, manifested as paronychia, which can damage the deck, horizontal depressions on the nail surface, and nail bed deck separation. Fungal infections are mainly Candida albicans infections, which can cause chronic paronychia, redness, swelling, and tenderness of the nail wrinkles, thickened decks, rough, and wing-shaped carp.
6. Diabetic foot disease mainly manifests as less sweat or no sweat in the limbs, low skin temperature, hyperpigmentation, paresthesia and hypopyrexia, atrophy of foot muscles, decreased tension, common intermittent claudication, and secondary gangrene of foot ulcers And osteomyelitis.

Diabetic dermatological examination

1. Physical Examination Physical examination reveals the characteristic skin damage of various types of diabetic skin diseases. For example, diabetic skin diseases can be seen in the round or oval dark red papules that occur in front of the tibia. Diabetic bullae can be seen below the knee joint. Blisters or tense vesicles, and diabetic foot pigmentation.
2. Histopathological examination. Histopathology of diabetic dermatosis showed thickening of dermal capillaries and small blood vessel walls, deposition of periodate-Schiff staining positive substances, extravasation of red blood cells and hemosiderin-containing deposits near blood vessels, and phagocytosis of tissue cells. Hemosiderin. Histopathology of diabetic bullae showed intraepidermal blisters, and the epidermis had no spinous layer loosening.

Diagnosis of diabetic skin disease

The patient has a history of diabetes, combined with characteristic skin lesions such as self-limiting dark red papules of diabetic dermatosis, intermittent claudication of diabetic foot and secondary gangrene, sudden self-limiting recurrent blisters of diabetic bullae, or Bullae can be diagnosed, and histopathological examination can help diagnosis and differential diagnosis.

Differential diagnosis of diabetic skin disease

Diabetic bullae should be distinguished from bullous pemphigoid, acquired bullous epidermolysis, pemphigoid, and bullous erythema erythema. Patients with diabetic bullae have a history of diabetes. Histopathology indicates intraepidermal blisters, no spinous layer release on the surface, and no autoantibody deposition on immunofluorescence examination.

Diabetic Dermatology Treatment

Mainly for the treatment of diabetes, control of blood sugar can relieve symptoms. In addition, symptomatic treatment can be provided by topical antipruritic drugs, antibiotic preparations or oral antibiotics.

Prognosis of diabetic skin disease

The prognosis for diabetic skin diseases varies. Diabetic bullae and diabetic dermatosis can resolve on their own; limited joint mobility and scleroderma-like syndrome in diabetic skin thickening can be alleviated or reduced by strictly controlling blood glucose; diabetic scleredema has a longer course It is long and stubborn; if the diabetic foot is not treated in time, severe gangrene needs amputation, which affects the quality of life.

Prevention of diabetic skin diseases

The prevention of diabetic dermatosis focuses on early detection and control of blood sugar to reduce its damage to microvessels. Secondly, skin trauma should be avoided.