Metabolism and Pathophysiology of Diabetes and Skin Involvement

Diabetes mellitus is a widespread increasing systemic disorder with a high impact on health systems worldwide. Skin disorders with diabetes can be found in about one third of all people with diabetes and frequently occur before the diagnosis, thus playing an important role in the initial recognition of underlying disease. Due to increased serum glucose level, different cell types like keratinocytes and fibroblasts but also endothelial cells, and neurons, are damaged. Thus different causalities like diabetic angiopathy and neuropathy skin manifestations may appear. The physiological changes cause skin reactions more often like xerosis and pruritus but also skin infections like mycoses or erysipelas. Necrobiosis lipoidica, scleredema adultorum of Buschke, and granuloma annulare are examples of frequent noninfectious skin diseases.