Skin Problems

The person with diabetes is prone to skin disorders that affect the general population, in addition to conditions unique to the disease itself.

Bacterial and fungal infections that are easily manageable in most patients can become chronic issues for a person with diabetes. Bacterial infections such as styes (infected eyelid glands); boils (infected hair roots or skin glands); and carbuncles (clusters of boils) can become chronic.

Fungal infections can also become problematic to the person with diabetes. Jock itch, most common in men, is manifested in red, itchy areas in the genital and thigh area. Women with diabetes can suffer from recurrent vaginal yeast infections, most commonly caused by Candida albicans. Overgrowth of this yeast produces symptoms of thick white vaginal discharge accompanied by an itching or burning sensation. Ringworm, circular red scaly patches that may itch or blister, is generally seen in the feet, groin, scalp, nails or trunk area. Athlete's foot, another fungal infection, causes the toes to become itchy, painful, and blistered.

Though they may tend to be recurrent, these conditions can usually be controlled or eradicated by topical antifungal creams and ointments or systemic oral antibiotics, as appropriate.

Among the diseases specific to people with diabetes, the most benign is diabetic dermopathy, or "skin spots." Present in 50% of diabetic men over age 50 and 29% of diabetic women over age 50, these red or brown scaly patches form on the front of the legs. Fortunately, though unpleasant in appearance, this condition is harmless and warrants no medical treatment. Eruptive xanthomas — waxy yellow or yellowish-brown areas often found over the elbows, knees, back or buttocks — can result from high triglyceride levels, which can be associated with the blood glucose imbalance of diabetes. Necrobiosis lipioidica diabeticorum, shiny yellow oval or irregular plaques seen on the anterior surface of the legs or the dorsal surface of the ankles, occurs in women two to four times more frequently than in men.

Symptoms associated with diabetic neuropathy are often noted in the skin. Nerve damage can result in hypersensitivity to light touch, itching, tingling, burning, a crawling sensation, and generalized diminished sensation. This numbness, along with poor blood supply to the extremities due to fatty deposits narrowing the arteries (atherosclerosis), can lead to skin ulceration and infection.

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