Being diagnosed with diabetes is life-changing. There is a slew of appointments, things to remember and check.
As you grow more comfortable with the diagnosis and care, it is important to educate yourself on other health conditions that may arise.
Here we take a look at a common skin problem among diabetics.
What is diabetic dermopathy?
Diabetic dermopathy, also known as shin spots or pigmented patches, is a common skin problem for people with diabetes. Skin is our largest organ. It is one of the most vital organs because its purpose is to protect all others. The skin encounters various toxins and environmental irritants and can be home to many bacteria.
When a person who has diabetes has elevated blood sugars, it can lead to poor blood circulation. As a result, the inability to heal efficiently and many cutaneous disorders can occur. If there is decreased blood flow to an area, injuries can leave longer-lasting bruises and skin lesions.
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Symptoms
Characteristically the spots look like oval or round, slightly indented scaly patches that are light brown or reddish, often on the front of your legs (pretibial patches) that can turn into ulcers.
While the shin is the most common part of the body affected, it can appear on other body parts such as the abdomen, thighs, and arms. These lesions may appear on anyone, particularly after an injury, but they are one of the most common skin problems found in patients with diabetes mellitus.
Causes & Risk factors
While there is a clear connection between dermopathy and diabetes, the cause is unknown. It appears that poor circulation may make you inclined to develop dermopathy.
Diabetic dermopathy tends to occur in older individuals with long-standing diabetes. Men aged 50 years and older with existing diabetic neuropathy are more likely to develop this than their female counterparts.
Diabetic Skin Conditions
Skin Tags
Skin tags, while harmless, can be an annoying skin formation where skin hangs from the stalk, growth at the base of the skin. While these happen independently, sometimes skin tags are a sign of diabetes.
Diabetic Bullae
Diabetic bullae are blister-like dermopathy lesions. They occur spontaneously on the feet and hands of diabetic patients.
Although rare, diabetic bullae are a distinct marker for diabetes. They are also more common in patients who have long-standing diabetes or multiple diabetic complications, particularly neuropathy.
Granuloma annulare
Granuloma annulare is elevated red bumps or diabetic dermopathy lesions. Young diabetics make up the majority of those suffering from this condition.
Granuloma annulare is common on the feet and hands. This condition strongly links with autoimmune disorders and hyperlipidemia.
Eruptive xanthomatosis
Eruptive xanthomatosis is a skin condition that causes small yellow-red bumps to occur all over the body. Its leading cause is excessively high blood lipid levels (triglycerides). Those with diabetes and subsequently elevated triglyceride levels are prone to eruptive xanthoma.
Stasis dermatitis
Stasis dermatitis occurs when there is venous insufficiency or poor circulation in the lower legs. Venous insufficiency happens when the valves in leg veins that help push blood back to the heart weaken and leak fluid.
As this occurs, water and blood cells pool in the lower legs. Venous insufficiency is caused by aging, but it can also signal a serious underlying medical condition, such as kidney or heart disease.
In addition, because the diabetic patient is susceptible to nerve damage and complications of neuropathy, this is a concerning condition.
Acanthosis nigricans
Acanthosis nigricans is skin darkening, commonly on the neck, groin, armpits, or behind the knees. The skin darkening can be the marker of hormonal changes, an indication of diseases like cancer or, in the case of diabetes, and an indicator of elevated blood sugar levels and insulin resistance.
During a physical examination, the doctor will look for signs of anthracosis nigricans. This skin condition may appear long before other physical symptoms of diabetes appear.
Prevention
A patient-centered approach to diabetic healthcare is vital. Establishing a good working relationship with your healthcare team is essential.
Because of the many comorbidities that can occur with diabetes mellitus, it is necessary to monitor:
- Blood sugar levels and HbA1c levels 2x (minimally) per year
- Blood Lipid Levels. Your Physician will watch this with blood draws that include total cholesterol, triglycerides, HDL, and LDL cholesterol levels.
- Blood Pressure. Keeping your blood pressure in a desirable range can help prevent diabetic neuropathy that can lead to a host of other conditions.
When to see a doctor
A diabetic patient must work closely with their healthcare team. Open, consistent communication will ensure a continuum of care and overall better health outcomes.
Unfortunately, there is a myriad of diabetic complications that can arise. Decreased blood flow in limbs can pose a risk do developing issues like diabetic blisters, which can lead to infection.
Diabetes foot care
The diabetic foot warrants daily foot checks. Nerve damage can cause a loss of feeling, making you unaware that something is amiss.
A blister, cut, or sore that is slow to heal should prompt you to call your physician. A daily foot check can be as easy as sliding a handheld mirror from under your bed and doing a visual inspection.
While completing this check for:
- Redness
- Corns
- Blisters
- Indentations that could indicate your shoe is ill-fitting
Daily foot care is imperative. Beyond doing a daily foot check, be mindful to:
- Wash your feet every day in warm water. Do not soak your feet for an extended period. Dry your feet thoroughly and apply lotion to the top and bottom, but not between your toes, which could lead to infection.
- Always wear shoes and socks or slippers, even inside, to avoid injury. Check that there aren’t any pebbles or other objects inside your shoes and that the lining is smooth. Wearing shoes with heels is not recommended. Try on and purchase later in the afternoon when your feet tend to be largest.
- Wear shoes that fit well. For the best fit, try on new shoes at the end of the day when your feet tend to be the largest. Break-in your new shoes slowly—wear them for an hour or two a day at first until they’re entirely comfortable. Always wear socks with your shoes.
- Trim your toenails straight across and gently smooth any sharp edges with a nail file. Have your foot doctor (podiatrist) trim your toenails if you can’t see or reach your feet.
- Do not use over-the-counter products for foot concerns. Always consult a podiatrist.
- Complete yearly foot exams with your medical doctor.
- Be physically active daily. Movement keeps your blood flowing.
Diagnosis
If an allergic reaction occurs after a new medication is started, the skin issue may be directly related to the drug. As indicated above, many of these skin concerns can signify that something is amiss with your blood sugar levels.
So getting in contact with your doctor is the first step. If you have existing diabetes, getting your blood sugar levels into the target range with help. A complete physical exam will entail a foot check and lab work.
Obtaining a visit with an optometrist with a dilated eye exam will look at small blood vessels and their health. Diagnosing diabetic dermopathy begins with a physical examination, where the doctor will examine the area affected, the shape, color, and size.
If the doctor feels that it is not diabetic dermopathy, they may suggest a skin biopsy may be acquired. A close tissue examination will determine if there are concerns with slow wound healing.
Treatment
If you have diabetes, you are more likely to have dry skin. If you have a skin disorder, infection, or poor circulation, it can additionally cause dry, itchy skin. There are many specialty creams for diabetics and even prescription-strength creams that can help.
If you are experiencing pain with a skin condition, a cortisone injection may help. These injections, commonly given in the joints of your body, can help with inflammation and pain.
Additionally, a topical steroid may be prescribed as an anti-inflammatory medication. They come in a variety of preparations, such as ointments, creams, or a liquid solution.
Conclusion
Diabetic dermopathy is a fairly common skin condition with diabetes. It is essential to be consistent with your medications, exercise routine, and healthy food choices.
Doing these will help keep your blood pressure and blood sugar levels close to desirable ranges. In addition, keeping your regularly scheduled visits will help address any concerns or prevent further complications.
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