Diabetes Self-Management Articles

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Diabetes and Your Skin
Protecting Your Outermost Layer

by May Leveriza-Oh, MD

Cellulitis requires prompt medical care. It is important that the health-care provider take a culture to determine what organism is causing the infection so that the right antibiotic is used. Once oral or intravenous antibiotics are started, the average time for healing is 12 days, with a range of 5–25 days.

Infectious gangrene is a serious condition that usually develops on the hands or feet at the site of an injury such as a laceration, needle puncture, or surgical incision. It can also occur in surgical incisions on the abdomen. The condition generally begins as cellulitis, which is followed by fever and other generalized symptoms as the infection rapidly spreads. The area then becomes dusky blue in color, and blisters appear and rupture, forming areas of black skin.

Since the mortality rate (death rate) for infectious gangrene is high, it is important that it is diagnosed early and treated aggressively.

Fungal infections
High blood glucose levels can also predispose people with diabetes to developing common fungal skin infections from organisms such as Tinea and Candida.

Fungal infections can occur just about anywhere, including the feet (Tinea pedis), the hands (Tinea manuum), the body (Tinea corporis), and the groin (Tinea cruris). Tinea pedis, or athlete’s foot, usually occurs in the web spaces between the toes or on the soles of the feet. Lesions are itchy and may develop vesicles (sacs filled with air or fluid) or may simply be red and scaly. It is usually contracted by walking barefoot on a contaminated floor. To help prevent athlete’s foot, it is always a good idea to wear slippers or shoes of some sort in public areas such as locker rooms. Tinea manuum is characterized by papules (small, raised pimples or swellings), vesicles, or scaling, typically on the dominant hand, and is associated with touching athlete’s foot lesions. Tinea corporis, or ringworm, presents as multiple red or pinkish circular lesions with a distinct, scaly border. In severe cases, the lesions may merge, forming large, discolored areas on the body. Tinea cruris, or jock itch, results in red to brownish, scaly, itchy lesions that cover the groin and sometimes extend to the pubic region and upper thighs.

Candidiasis of the skin tends to occur in folds of skin such as the underarms, groin, under the breasts, and between the buttocks. This condition begins with pustules on a red base that eventually result in softened, thickened areas of skin.

All of these superficial fungal infections are treated in more or less the same way. Applying antifungal creams two to three times daily for approximately two to four weeks should clear the infection. Keeping the affected areas dry, and using medicated powders in skin folds to reduce friction and moisture are also helpful measures. Infections that don’t respond to topical treatment may be treated with oral antifungal medicines.

Skin conditions associated with diabetes
The following skin conditions are strongly associated with having diabetes, but they can occur in people who don’t have diabetes as well.

Acanthosis nigricans. This condition is characterized by the formation of velvety, brownish, thickened areas of skin in the groin, underarms, under the breasts, and in the creases of the neck. The affected skin may become leathery or warty or develop tiny skin tags. Acanthosis nigricans is common in people who are obese, but it may also be associated with certain forms of cancer as well as endocrine disorders such as polycystic ovarian syndrome (PCOS), acromegaly, Cushing syndrome, and diabetes.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

 

 

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