title: Cutaneous Manifestations of Diabetes Mellitus: A Review.
abstract: Diabetes mellitus is a widespread endocrine disease with severe impact on health systems worldwide. Increased serum glucose causes damage to a wide range of cell types, including endothelial cells, neurons, and renal cells, but also keratinocytes and fibroblasts. Skin disorders can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Noninfectious as well as infectious diseases have been described as dermatologic manifestations of diabetes mellitus. Moreover, diabetic neuropathy and angiopathy may also affect the skin. Pruritus, necrobiosis lipoidica, scleredema adultorum of Buschke, and granuloma annulare are examples of frequent noninfectious skin diseases. Bacterial and fungal skin infections are more frequent in people with diabetes. Diabetic neuropathy and angiopathy are responsible for diabetic foot syndrome and diabetic dermopathy. Furthermore, antidiabetic therapies may provoke dermatologic adverse events. Treatment with insulin may evoke local reactions like lipohypertrophy, lipoatrophy and both instant and delayed type allergy. Erythema multiforme, leukocytoclastic vasculitis, drug eruptions, and photosensitivity have been described as adverse reactions to oral antidiabetics. The identification of lesions may be crucial for the first diagnosis and for proper therapy of diabetes.
authors.affiliation: Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.
authors.forename: Ana Luiza
authors.initials: AL
authors.lastname: Lima
authors.affiliation: Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Illing
authors.affiliation: Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Schliemann
authors.affiliation: Department of Dermatology, University Hospital Jena, Erfurter Straße 35, 07740, Jena, Germany. elsner@derma-jena.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Elsner
mesh_terms: D003881:Dermatomycoses / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D017719:Diabetic Foot / Q000209:etiology; D016460:Granuloma Annulare / Q000209:etiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D011537:Pruritus / Q000209:etiology; D012592:Scleredema Adultorum / Q000209:etiology; D012871:Skin Diseases / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin