In diabetes, under the influence of pathological changes in metabolic processes, develop multiple complications that affect the functions of the internal systems of the body.
Almost all organs are affected, including the integuments.
Spots, ulcers, hardened skin are a frequent manifestation of the disease in diabetics.
Causes of skin lesions
Disorders of carbohydrate metabolism, characteristic of diabetes, cause the formation of elevated levels of insulin in the body or, with a lack of hormone, an increased concentration of sugar in the blood. Overabundance of insulin or glucose leads to malnutrition of the dermis and structural changes in epithelial cells. The accumulation of metabolic decomposition products in the cells provokes damage to the hair follicles.
Increased sugar content negatively affects blood circulation and the function of nerve endings located in the skin. This leads to a decrease in the sensitivity of the limbs, an increase in the tendency to the appearance of injuries to the legs. In addition, due to the disease, the body's defenses are weakened and the soft tissue regeneration function is impaired.
As a result, diabetics do not immediately notice the injuries that have appeared on the body, because of the low rate of cell repair, the wounds do not heal for a long time, and because of weakened immunity, bacterial or fungal infections join the overall picture.
Thus, the causes of the appearance of skin spots in diabetes include:
- elevated blood glucose;
- high concentration of insulin (insulin resistance);
- violation of blood circulation in the limbs;
- reduced immunity;
- damage to the nervous system (neuropathy);
- allergic reaction to insulin and sugar lowering drugs;
- fungal and bacterial infections.
There are a number of factors that can trigger the development of pathology:
- Obesity. Fat people find it hard to find damage to the body. In addition, these patients have increased sweating and large skin folds, which leads to the appearance of rashes, scuffs, calluses and facilitates the penetration of the infection.
- Nicotine and alcohol addiction. Harmful habits increase the dehydration of the skin and contribute to the narrowing of blood vessels, which impairs circulation.
- Wearing narrow and uncomfortable shoes. This leads to the appearance of corns and scuffs.
- Inadequate skin care. As a result, the integuments dry up, coarse areas and cracks appear.
- Elderly age. Age-related changes cause a decrease in skin tone and drying of the skin, especially in the legs, groin and perineum.
Attempts to engage in self-healing of damage in the presence of diabetes mellitus contribute to the progression of skin diseases and the appearance of complications.
Red spots in diabetic dermathopathy
Disseminated annular granuloma
Against the background of high blood glucose and frequent urination, the blood supply to the tissues is disturbed and there are signs of dehydration.
As a result, the condition of the skin changes, they become coarser, coarse areas appear on the foot, the skin becomes dry and sluggish, and cracks form on the heel. Itching and peeling occurs, hair begins to fall out.
Skin changes color: a gray tint or jaundice may be observed. Due to the dilated capillaries, a blush (diabetic rubeosis) appears on the cheeks, which can often be seen in children with diabetes.
Skin pathologies can be divided into several groups:
- medicinal - arising on the background of insulin therapy and taking sugar-reducing drugs (allergic dermatosis, urticaria, post-injection lipodystrophy, eczema);
- primary diseases that have developed due to angiopathy and metabolic disorders (xanthomatosis, lipoid necrobiosis, diabetic blisters, diabetic dermatopathy);
- secondary - infection with bacteria or fungi on the background of endocrine disorders.
Therapy of skin lesions is hampered by a decrease in the rate of soft tissue regeneration, therefore, it lasts a long time, with frequent recurrences.
In patients with diabetes, angiopathy is formed. A manifestation of the pathology is diabetic dermopathy (see photo), which often affects middle-aged and elderly men.
The main symptom is brown spots, covered with scales, painless and non-itchy, appearing on both limbs and disappearing on their own after a couple of years.
If diabetes is short-lived, the appearance of round maroon spots with a clear contour is a sign of erythema. Such lesions are large in size, often appear on the body and are accompanied by a slight tingling. The spots disappear after a few days without any treatment.
Obese diabetics develop a complication such as black acanthosis (see photo). Brown spots appear in the armpits and neck folds.
On the damaged area, the skin is velvety to the touch, with a clear skin pattern.
Subsequently, a black spot is formed from a dot. The disease is most often benign and spots soon disappear, but there is also a malignant form of pathology.
The same darkening can be observed on the joints of the fingers. There are similar skin lesions as a result of an excess of insulin in the body, which happens with insulin resistance.
Manifestations of lipoid necrobiosis
Lipoid necrobiosis - what is it? This pathological lesion of the skin on the legs, arising against the lack of insulin. The disease is more common in women suffering from type 1 diabetes.
First, there are red spots on the legs (see photo), raised above the skin, then they grow and turn into shapeless atrophic plaques.
A brown sunken spot forms in the center, in place of which a painful ulcer forms over time.
Complex therapy of skin disease is the following appointments:
- drugs to restore blood supply (Aevit, Curantil, Trental);
- stain treatment with Ftorocort, Dimexide, Troxevasin;
- insulin therapy inside ulcers and Heparin injections;
- drugs that normalize lipid metabolism (Lipostabil, Clofibrate);
- laser therapy;
- phonophoresis with hydrocortisone.
In difficult cases, plastic surgery is used.
Another form of dermatological damage in diabetes mellitus is the appearance of itching in the folds of the skin. Pathology usually occurs within five years after the development of diabetes and is more common in women.
Physical or red spots appear on the elbows, abdomen or groin. The points merge with time, the affected skin area dries and cracks. At night, itching intensifies.
On the foot or toes of the upper and lower extremities, diabetic blisters can form, reaching a size of several centimeters.
The color of the dermis in places of damage does not change, the rash may be accompanied by a slight itching or tingling, and may not deliver pronounced discomfort. Bubbles contain bloody or clear liquid that does not contain pathogenic microflora. After three to four weeks, the bubbles disappear, leaving no scars.
Infectious skin lesions
Spots that appear in elderly diabetics in the groin, between the fingers, in the folds of the skin and in the perineum may be signs of candidomycosis.
The skin reddens, cracks and erosion are formed on it with a light contour and a bluish-red shiny surface.
Adjacent skin areas may be covered with fine bubbles. All this is accompanied by intense itching.
A microbiological analysis of the scraping taken from the erosion surface is carried out to confirm the diagnosis.
Therapy consists of physiotherapy and taking Fluconazole or Itraconazole. For external use is assigned to Clotrimazole, Exoderil or Lamisil.
In addition to candidiasis on the background of diabetes, such infectious lesions are often diagnosed:
- diabetic foot ulcer;
Antibacterial drugs are used in the treatment of diseases, but skin pathologies are difficult and require long-term therapy. Skin diseases are difficult to treat and make it difficult to effectively compensate for high glucose levels.
In the damaged areas, a substance is synthesized that acts on insulin, destroying the hormone. In addition, the body seeks to get rid of infection and inflammation and includes a defense mechanism, which leads to an even depletion of immunity.
Therefore, to speed up the result, diabetics increase the dosage of insulin, prescribe drugs that strengthen the body's defenses, and in difficult cases, resort to surgery.
Compliance with preventive measures will help prevent infection and alleviate the course of the disease:
- protect the skin from burns, abrasions, scratches and wounds;
- inspect the skin regularly and, after detecting damage, treat with an antiseptic;
- select comfortable, suitable shoes, avoiding the formation of corns;
- carrying out skin care, do not use sharp objects, hard washcloths, do not use soap;
- hygiene procedures should be carried out regularly using soft, non-irritating skin gels;
- use skin care emollients and moisturizers.
Video material about skin diseases in diabetes:
Having found a festering place or wound of a significant size, do not try to treat the damage yourself. In this case, you should urgently visit the doctor and prevent deterioration.