Diabetes affects the skin via its effects on the collogen synthesis and microvascular flow.
Some skin lesions are more common in those with diabetes and some are specific to diabetes.
Necrobiosis Lipidica diabeticorum (NLD):
Occurs in about 0.3-1% of those with diabetes (more common in Type 1). F4x>M; usually 40-60 years
Slowly enlarging plaque; slightly elevated border; central portion is initially erythematous, but becomes yellow or sclerotic; vary in size from a few mm to several cm.
Most are pretibial or around medial malleolus.
Ring like (annular) papules that tend to coalesce.
Flesh coloured plaque with papular border – appear ring like
Diabetic Dermopathy (‘shin spots’):
Red to brown oval papules up to 1cm in diameter, that progress to shiny pigmentation or depressed scales; common on anterior leg; minor trauma is speculated as cause; common – affects up to 50%; tend to resolve after 1-2 years
Diabetic blisters/bullosis diabeticorum(BD)/diabetic bullae:
Blisters that occur spontaneously on the extremity – painless and not pruritic; uncommon.
Vary from several mm to several centimetres in diameter; usually symmetrical; may occur on dorsum of foot and result in shoe pressure problems
Resolve spontaneously in 2 – 5 weeks
Diabetic thick skin: