Fit & Proper: Skin can warn about diabetes

The skin is the largest organ of our body and the most ignored as well. Often we overlook the changes in our skin type and colour. And if we do notice them, we mostly blame these differences on pollution, sun tan or ageing. In reality, skin changes are connected to numerous disease, one of them being diabetes. Skin problems can be either the cause or a symptom of diabetes. Here's what you need to look out for:

Acanthosis nigricans: This mostly strikes overweight people and is usually a prologue to diabetes. It results in darker, thicker and velvety skin; predominately on skin folding areas such as the sides of the neck, armpits and groin and sometimes on the hands, knees and elbows.

Diabetic dermopathy: Diabetes causes this condition in which changes occur in the blood vessels supplying to the skin. It is also termed as shin spots and appears to be light brown, shiny and scaly, round or oval patches/lesion of thin skin over the front lower parts of the legs. They do not hurt, itch or burn and are often confused for age spots.

Necrobiosis lipoidica diabeticorum: This is a complex version of diabetic dermopathy and most likely occurs in adult women. A shiny scar with a violet border appears where the blood vessels under the skin may become easily visible.

They sometimes turn itchy and painful with the spots sometimes cracking open.

Eruptive xanthomatosis: This is caused by intensive diabetes and results in firm and yellow pea-like bump in the skin with an itchy red halo. It occurs commonly on the rear of the hands, feet, arms, legs and buttocks. People with high cholesterol and fat, especially young type 1 diabetic men, are the most likely subjects.

Vitiligo: Similar in looks to albinism, this condition occurs upon the destruction of the colour pigmentation producing cells (melanin), and appears as irregular and blotchy patches on the hand, face or chest.

Diabetic blisters (bullosis diabeticorum): Caused by intensive diabetes, they look like sores or burn blisters that are painless and occur on the fingers, hands, toes, feet, legs or forearms. They easily heal on their own in about three weeks.

Digital sclerosis: This condition is prevalent in about one-third diabetics wherein one develops tight, thick and waxy skin on the hands, toes and forearm. This also results in stiffness in the fingers, knees, ankles or elbows.

Disseminated granuloma annulare: These are sharply defined ring or arc-shaped bumps on the skin, most common in the fingers and ear lobes. They are usually red, red-brown or skin colour.

Some generic skin issues that may or may not occur owing to diabetes are:

Bacterial infections: Diabetic people tend to have more bacterial infections (the most common one being staphylococcus bacteria) such as nail infections, styes (glands of the eyelid infected), boils, folliculitis (hair follicles infected) and carbuncles (deep infections of the skin and the underlying tissues).

Fungal infections: For diabetics, Candida albicans creates itchy rashes with tiny blisters and scales mostly under the breasts, nails, edge of the mouth, foreskin and armpits. A few other infections in the category are jock itch, athlete's foot and ringworm.

Sanjoy Paul,
Senior consultant diabetologist, Apollo Sugar, Hyderabad