Abstract
Dermatologic problems are common in diabetes, with approximately 30% of patients experiencing
some cutaneous involvement during the course of their illness. Skin manifestations
generally appear during the course of the disease in patients known to have diabetes,
but they may also be the first presenting sign of diabetes or even precede the diagnosis
by many years. The skin involvement can be autoimmune in nature, such as acanthosis
nigricans, necrobiosis lipoidica, diabetic dermopathy, scleredema, and granuloma annulare,
or infectious in the form of erythrasma, necrotizing fasciitis, and mucormycosis.
Pharmacologic management of diabetes, in addition, can also result in skin changes,
such as lipoatrophy and lipohypertrophy, at the site of injection of insulin, and
oral antidiabetic agents can cause multiple skin reactions as adverse effects. The
management of these cutaneous manifestations is tailored according to the underlying
pathophysiology, but a tight control of blood glucose is a prerequisite in all management
strategies.
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