The skin, subcutaneous tissue and mucous membranes undergo changes in diabetes. The skin of patients with decompensated diabetes is dry, peeling, its turgor is reduced, cracks are frequent in the corners of the mouth.
Dry seborrhea in the hair. Due to itching and seborrhea, seborrheic dermatitis occurs.
The nails are thickened, especially on the legs, there is subungual hyperkeratosis.
In adolescence, with labile diabetes, a characteristic blush (diabetic rubeosis) is observed due to the expansion of skin capillaries. Patients with long-term diabetes can develop diabetic dermatopathy in the form of large, atrophic, hyperpigmented, flaky spots on the anterior surface of the lower leg.
Infrequent, but very characteristic lesions are lipidoses (lipoid necrobiosis), carotenemia (yellow color of the palms and soles), and skin itching (general or local). In patients with severe forms of angiopathy, trophic ulcers on the skin of the legs and feet are observed.
Due to the decrease in the reactivity of the body in patients with diabetes, pustular and mycotic lesions of the skin and mucous membranes are frequent. Furunculosis is observed in diabetes 2 times more often than in the general population and indicates prolonged decompensation of the disease. Mycotic lesions occur in the form of epidermophytosis of the feet. In women with persistent decompensation and severe glucosuria, candidiasis of the mucous membranes of the external genitalia and vagina develops. Generalized candidiasis, stomatitis, and damage to the lungs and bronchi are less common.
In severe decompensated diabetes with signs of dehydration, the oral mucosa is bright red, dry, and sometimes has a “lacquered” appearance. The pathognomonic symptom of diabetes is damage to the gums and teeth – periodontal disease, which occurs in almost all patients. The degree of its manifestations is different: gingivitis, aphthous stomatitis, periodontal disease, alveolar pyorrhea.
Juvenile diabetes, especially decompensated, is often characterized by exhaustion. In non-insulin-dependent diabetes, 80% of elderly patients have varying severity of dysplastic obesity – fat deposition on the upper half of the body, abdomen with thinning of the lower extremities – upper android (Cushingoid) type of obesity.
Rare forms of impaired fat metabolism include generalized atrophy of the subcutaneous basis – lipoatrophic insulin-resistant diabetes.