[Skin manifestations of diabetes mellitus]

Cutaneous manifestations of diabetes mellitus are common and manifold. In the course of their disease, 30-70% of type I and type II diabetics are affected. At a closer look, the majority of all diabetics would show preclinical alterations of the vessel walls or of the connective tissue. In the diabetic patient, it is important to be familiar with and to look for the possible cutaneous alterations, which have to be diagnosed on mainly clinical grounds. Some of them can be a consequence or an accompanying symptom of a poorly controlled diabetes and therefore they can potentially help the responsible physician to prevent more serious complications. Some of these dermatoses are so called marker lesions and can precede the manifestation of the diabetes by years. The exact pathogenesis of most of these dermatoses is unknown. It is reasonable to assume though that vessel and connective tissue alterations as well as the impairment of the immune system and other associated metabolic changes caused by the diabetes play an important role.