Through some skin lesions, it is possible to find out whether a person has diabetes. Can you believe it?
The image comes from the Internet
For diabetes, we all know that it is a chronic disease that is very annoying. On the one hand, this disease does not have much discomfort at the beginning, can eat and drink, and the mental state is particularly good, so it is difficult to detect early; on the other hand, this disease cannot be cured, and over time, it will damage our heart, brain and kidneys and other important organs, and even uremia, coronary heart disease, stroke and so on.
And once it is found that there is diabetes, it is basically in a state of not having enough to eat and starving. It's annoying, and it's hard to prevent.
Once, shortly after I graduated from college, an elderly neighbor of mine had a recurring folliculitis attack on the back of his neck that did not heal. I mobilized him to come to our hospital to test his blood sugar. Because the conditions were generally poor at that time, the neighbor said that it was just a skin lesion, his body was very good, and there was no need to spend some unjust money.
Later, it dragged on for half a year, and there was really no way to go to the hospital for examination. Sure enough, it was diabetes. Through the active treatment of diabetes, folliculitis gradually recovers.
Many people, including some doctors, tend to pay more attention to diabetic nephropathy, diabetic neuropathy, cardiovascular disease, diabetic foot and so on. Because these complications can lead to disability and even life-threatening for the patient. So everyone attaches great importance to it. Less attention is paid to changes in diabetic skin.
In fact, diabetic skin lesions, but also one of the most common complications of diabetes, not only a wide range of lesions, a wide range of types. It can also occur at various stages of the course of diabetes.
Historically, there have been many diabetic patients with skin lesions as the first manifestation. The most common of these are skin infections, pruritus, eczema, etc. Therefore, when we were in college, the teacher told us: if a patient has repeated skin lesions, we must test the patient's blood sugar and rule out the possibility of diabetes.
There are many causes of diabetic skin lesions. It can be seen in the following conditions: skin lesions due to microvascular disorders, skin lesions due to nerve damage, skin lesions caused by metabolic disorders, skin infections, and even some hypoglycemic drugs may also cause skin lesions.
The manifestations of diabetic skin lesions are also diverse.
For example, itchy skin. 1 in 5 diabetic patients with symptoms of skin itching. This itching can be systemic or localized. Female patients also develop stubborn vulvar itching, which seriously affects the patient's quality of life and work.
Take, for example, skin infections. About 1/3 of diabetic patients will be complicated by different degrees of skin infections. There are often boils, folliculitis, impetigo and carbuncles. At the same time, it is easy to have fungal skin infections, such as tinea mandibularis, tinea corpus and so on. The main reason for skin infections in diabetic patients is that the glycemic and glycogen content of the skin tissues of the patients is increased, which is more suitable for the growth of bacteria and fungi.
For example, diabetic bubbles. It is a blister that occurs on the hands and feet of the patient. It often occurs suddenly, varies in size, the foam wall is thin, and the inside of the bubble is a clear liquid. It usually heals itself after a few weeks without scarring; there is also a type of diabetic vesicle that heals, leaving pigmentation and mild atrophy on the skin. Diabetic vesicles tend to recur and do not appear such as itching and pain.
For example, diabetic eruptive xanthelasma tends to occur on the skin of the patient's knees, elbows, back, or buttocks. Yellow papules or small nodules the size of rice grains to soybean grains appear, with a shiny surface and generally no self-conscious symptoms such as itching.
There are also diabetic rashes and skin paresthesias caused by diabetes, skin numbness, pinprick sensation, pain or burning sensation, etc., especially the patient's foot is more likely to occur paresthesia.
Diabetic foot, for example, is caused by vascular complications and motor, sensory, and autonomic neuropathy, and skin lesions gradually appear. Coupled with dry skin and decreased pain, the skin is prone to cracking, cellulitis or deep tissue infection occurs, and the lesion begins to appear blisters at the tip of the toe and the plantar, while the foot appears painful, hypersensitive and paresthesia. Paralysis and even sensory loss may occur later. In severe cases, amputation is eventually required.
For example, diabetic sweating abnormalities are often reduced or no sweating in the lower limbs, while facial sweating increases, and the patient chews something and sweats in the distribution area of the cervical ganglion within a few seconds.
There is also waxy skin and joint stiffness, annular granulomas, diabetic scleroderma, yellow skin and so on.
There are also hypoglycemic drugs, such as insulin, oral hypoglycemic drugs that may cause skin allergies. Local skin redness, swelling, nodules, etc. appear. There are also manifestations such as causing generalized urticaria. There are also sulfonylurea hypoglycemic drugs, which may cause panthematous erythema on the skin. After the diagnosis of allergy should be changed to other hypoglycemic drugs, skin symptoms can generally return to normal.
In fact, all diabetic skin lesions, as long as blood glucose is actively controlled in the early stage of diabetes, so that blood sugar continues to stabilize in the normal range, skin lesions will gradually recover.
This is one of my patients - diabetic skin lesions