Skin manifestations in rare types of diabetes and other endocrine conditions

Abstract

As the most visible and vulnerable organ of the human organism, the skin can provide an impression of its state of health. Rare forms of diabetes and endocrinopathies are often diagnosed late or primarily misinterpreted due to their rarity. Skin peculiarities associated with these rare diseases may be indicative of the underlying endocrinopathy or form of diabetes. At the same time, rare skin changes in diabetes or endocrinopathies can also be a major challenge for dermatologists, diabetologists and endocrinologists in optimal patient and therapy management. Active collaboration between these different specialist groups can therefore lead to increased patient safety, better therapeutic success and more targeted diagnostics.

Keywords: cutaneous effects of rare diabetes; rare dermatologic changes in endocrine disorders; rare endocrinopathies; rare types of diabetes.

Figure 1

Skin changes in diabetes mellitus.

Figure 2

Skin changes in childhood diabetes. Skin irritation and scratching artefacts caused by a CGM sensor.

Figure 3

Skin changes in childhood diabetes. Typical skin lesions of necrobiosis lipoidica in a girl suffering from type 1 diabetes and low metabolic control.

Figure 4

Typical skin changes of acanthosis nigricans at cervical (A), axillary (A, B) and nuchal (C) localisation in a youth with paediatric diabetes and poor metabolic control.

Figure 5

Typical skin changes of striae distensae and accompanying hirsutism in a teenage girl with type 2 diabetes mellitus and polycystic ovarian syndrome.

Figure 6

Characteristic skin lesion in a girl with Cushing's syndrome. In addition to the facial mottling with incipient acne vulgaris, there is also an accumulation of fat in the neck area.

Figure 7

Classic skin changes that are indicative of hyperpigmentation, for example in the context of adrenal insufficiency. The hyperpigmentation can manifest itself all over the body. Here is an example on the hands (A), the gums (B), the nipple (C) and the tongue (D).