Diabetes And Problems With Skin And Nails

There are a number of skin and nail problems that are more commonly seen in people with diabetes. These include the following:

• Fungal infections of the skin (athlete's foot) and nails (onychomycosis), which require treatment with antifungal medicines.

• Acanthosis nigricans, a darkening of the skin at the back of the neck and under the armpit. The skin has a velvety feel. This condition occurs in people with type 2 diabetes who are very insulin resistant. It does not require any treatment.

• Necrobiosis lipoidica diabeticorum. This is seen mostly in people with type 1 diabetes. There is a thinning of the skin on the shins with a reddish yellowish discoloration. Sometimes it can be ulcerated in the middle. Treatment is usually with steroid injections or creams.

• Lipohypertrophy, a localized swelling, is caused by repeated insulin injections in one spot. Insulin absorption becomes more erratic in these areas. Stopping injections of insulin in the affected area usually leads to recovery.

• Shin spots, or diabetic dermopathy, are brown, oval patches on the shins (and sometimes on the forearms) of people with diabetes. Men are more prone to this than women. There is no treatment for it.

• Scleredema diabeticorum, a firm swelling and thickening of the skin of the shoulders and upper back. This condition can be itchy. Treatments include steroid ointment and a medicine called methotrexate.

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