Context: Diabetes is considered a major health problem, mainly due to its various debilitating complications, including blindness, renal failure, heart attack, stroke, limb amputation, and even death in millions of patients per year. Skin manifestations of diabetes are common in everyday clinical practice but often remain neglected. This review aims to highlight the pathogenetic mechanisms and clinical picture of skin conditions, associated with diabetes mellitus. Evidence Acquisition: The skin manifestations of diabetes mellitus are related to blood glucose levels. Initially, glycemia affects skin homeostasis by inhibiting keratinocyte proliferation and phagocytosis and inducing endothelial cell apoptosis, while in later stages, the involvement of the peripheral nervous system and vascular changes (micro and macroangiopathy) become the leading pathogenetic factors. Results: There are different classifications of skin changes in diabetes, depending on the frequency, the onset, or the type of diabetes. The most convenient classification from the practical point of view subdivides cutaneous manifestations into four categories: (A) cutaneous manifestation specific to diabetes; (B) compatible dermatosis not specific to diabetes; (C) skin infection associated with diabetes; and (D) skin manifestation due to antidiabetic therapy. Conclusions: Diabetes mellitus is associated with a wide range of dermatological disorders. Their recognition is important for the early diagnosis of diabetes and therefore might be helpful to reduce the complication rates.
Neurofibromatosis type I is an autosomal dominant genetic disorder with an incidence of about 1 in 3000 births. Apart from the typical skin involvement NF1 may affect multiple organs with ocular, neurological, skeletal and cardiovascular manifestations. We present a case of a 38-year-old man with multiple café-au-lait macules and hundreds of neurofibromas disseminated on the trunk and extremities dating from childhood. To establish the diagnosis and to exclude any complications we performed multiple examinations, including skin biopsy, laboratory investigations, ophthalmologic assessment, consultations with a neurologist, internist and orthopedist, etc. The treatment of cutaneous NF1 is mainly symptomatic. Surgical excision aims to achieve cosmetic results. Recently novel and perspective conservative therapies have been investigated. In order to ensure better outcome for the patients with NF1 long-term multi-disciplinary approach is advised.
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