skin diseases commonly seen in diabetic patients dr. au tak shing mbbs (hk), mrcp (uk), fhkcp, fhkam...
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Skin diseases Skin diseases commonly seen in commonly seen in diabetic patientsdiabetic patients
Dr. Au Tak ShingMBBS (HK), MRCP (UK),
FHKCP, FHKAM (Medicine), FRCP (Edin), Dip Derm (Lond), Dip GUM (LSA),
DCH (Lond), DFM (CUHK),Specialist in Dermatology and Venereology
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Skin disease and DM
Skin manifestations of DM Skin disease as side effects of treatment for
DM Treatment of skin disease resulting in DM
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Dermatophyte infection
Tinea is common in DM patients May not be more common than general
population Need for treatment is even stronger Watch out for secondary bacterial infection
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Infection or not?
Distribution is a very important clue
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Distribution
Fungal infection is usually asymmetrical
Dermatitis is usually symmetrical or corresponding to the primary cause
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Distribution is a very important clue Morphology of an individual lesion
Infection or not?
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Candidiasis
More common in DM patients Vulvo-vaginitis Balano-posthitis Can be the first sign of DM
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Diabetic dermopathy
Quite common Multiple, asymptomatic, irregularly shaped,
discrete, atrophic, brown macules resembling scars
Shins Intimal thickening and deposition of PAS-
positive fibrillary material in vessel walls Microangiopathy elsewhere
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Acanthosis nigricans
Velvety hyperpigmentation of intertriginous areas
Less often on extensor surfaces Commonly associated with insulin resistan
ce Obesity, darkly-pigmented patients
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Diabetic bullae
Bullous diabeticorum Non-inflammatory bullae on lower extremi
ties Pathology uncertain
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Bullous pemphigoid
Autoimmune process that affects the dermo-epidermal junction
Elderly Multiple intact bullae Investigation: skin biopsy for histology an
d immunofluorescence study Treatment: oral steroid +/- other immuno-s
uppressants
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Necrobiosis lipoidica
Yellow atrophic patches often on shins Erythematous border Ulceration Not always associated with DM
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Disseminated granuloma annulare
Annular lesions composed of papules Usually smooth surface Controversy about relation with DM
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Neuropathic ulcers
Non-painful ulcers at feet Pressure points
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Acral dry gangrene
Due to vascular disease
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Eruptive xanthomas
Reddish yellow papules Developing over weeks to months Elevated serum triglycerides in patients wit
h poorly controlled DM Good control of DM leads to resolution
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Contact Dr. Au Tak Shing
Unit 502, Hing Wai Building, 36 Queen’s Road Central, HK (tel: 28100680)
香港中環皇后大道中 36號興瑋大廈 5樓 502 室(星期一、三、五)
Unit 922, Argyle Centre Phase One, 688 Nathan Road, Mongkok (tel: 23926006)
九龍旺角彌敦道 688 號旺角中心第一座 9樓 922 室(星期二、四、六)
Email: [email protected]