Medical Education Committee
Our talk today was given by Jeffrey Cohen, MSIV, on cutaneous manifestations of chronic disease.
The three main chronic diseases we see in clinic are diabetes, hypertension, and obesity. Today, Jeff discussed common skin conditions associated with diabetes and obesity.
Diabetes: The most common skin condition associated with diabetes is acanthosis nigricans, a velvety hyperpigmentation found in the folds of the skin. Acanthosis nigricans is a product of insulin resistance.
Diabetic patients also have an increased risk of bacterial and fungal infections. Generally, bacterial and fungal infections are differentiated by appearance: green pigment is indicative of bacterial infection with pseudomonas, while central clearing in red patches and flaky edges indicate fungal infection.
Diabetic ulcers are present in 15-25% of patients with Type 2 Diabetes. These are a result of vasculitides and neuropathies due to chronically elevated blood glucose.
Diabetic bullae (blistering), dermopathy, and pigmented purpuric dermatosis are less common but notable because they correlate with high levels of hemoglobin A1C.Obesity:
Patients with obesity are at increased risk of developing intertrigo, psoriasis, and stasis dermatitis.
Intertrigo is skin inflammation due to rubbing and abrasion in intertriginous zones. Intertrigo can be complicated by candida infection.
Intertrigo is skin inflammation due to rubbing and abrasion in intertriginous zones. Intertrigo can be complicated by candida infection.
Psoriasis is a common inflammatory skin disease characterized by scaly plaques.
Stasis dermatitis is a chronic inflammatory skin condition that typically presents on the lower extremities. The hemostasis that causes stasis dermatitis is the result of venous hypertension and venous valve insufficiency.
Take Home Points:
- Diabetes and obesity put patients at increased risk of developing certain skin conditions.
- It is important to perform a thorough physical exam in order to prevent and treat cutaneous lesions, some of which (like diabetic ulcers) can be life-threatening.
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