Skin Manifestations of Common Diseases

(Diabetes, Thyroid Diseases, Inflammatory Bowel Disease)

Prepared by:

Alaa Ali Amer

12111953

Dr. Khaled Najjar

Introduction

Skin manifestations are a phrase that describes the cutaneous signs, symptoms, or physiological
modifications of a non-dermatological disorder. The skin often acts as a marker for underlying
diseases (Benedetti, 2021).

Skin Manifestations of Diabetes Mellitus

Dermatologic manifestations of diabetes mellitus have different health implications, ranging

from those that are concerning to potentially life-threatening. Understanding the cutaneous
manifestations of diabetes mellitus can provide information about a patient's current or previous
metabolic status. The recognition of such findings may help in the diagnosis of diabetes or may
be followed as a marker of glycemic control.

1. Acanthosis Nigricans (AN)

Chronically, it appears as a series of weakly defined

plaques with grey to dark-brown hyperpigmentation and a
thickened velvety to verrucous texture. AN usually located
in the back of the neck, axilla, elbows, palmer hands (also
known as "triple palms"), inframammary creases, and
umbilicus. AN can appear before a clinical diagnosis of
diabetes; the occurrence of AN should prompt a check for
diabetes mellitus and other symptoms of insulin resistance.
Figure 1: Shows Acanthosis Nigricans

2. Diabetic Dermopathy.

Also called shin spots are the most common cutaneous finding
in diabetics. They are round top oval atrophic hyperpigmented
lesions that appear on the lower extremities. Early lesions are
usually elevated and eventually flatten, and they occur
bilaterally with asymmetric distribution.

Figure 2: Shows Diabetic Dermopathy

 3. Diabetic Foot Syndrome

It begins with callosities and dry skin due to neuropathy,

and progresses to chronic ulcers and a variety of other foot
deformities. It can be neuropathic, ischemic, or mixed. The
skin of affected people is more susceptible to fungal
infection, particularly in those with type 2 diabetes, and the
toe webs are a typical entry point for fungi, which can then
infect and complicate ulcers.
Figure 3: Shows Diabetic Foot Syndrom

Other skin manifestation associated with diabetes:

Diabetic Thick Skin, Scleroderma-Like Skin Changes, Limited Joint Mobility, Scleredema
Diabetocorum, Bullosis Diabeticorum.

Skin Manifestations of hyperthyroidism

Common skin manifestations of hyperthyroidism include flushing

of the face, erythema of the palms, and hyperhidrosis of the palms
and soles. The epidermis is found to be thin but not atrophic like
the one would observe in Cushing syndrome.

Onycholysis, or separation of the distal nail plate from the nail

bed, is a common occurrence that can also be seen in
hypothyroidism, psoriasis, allergic contact dermatitis, and trauma.
Pretibial myxedema, also known as thyroid dermopathy, is often Figure 4: Shows flushing

associated with Graves’ ophthalmopathy.

Figure 5: Shows pretibial myxedema Figure 6: Shows Onycholysis Figure 7: Shows erythema
Skin Manifestations of hypothyroidism

Congenital hypothyroidism, a condition caused by thyroid

hormone deficiency in fetal life, commonly demonstrates
intellectual disability. In addition, these individuals may
develop signs of myxedema, orbital hypertelorism, a protruding
abdomen with associated umbilical hernia, acral swelling, a
Figure 8: Shows abdominal protrusion with
clavicular fat pad, and slow growing nails. umbilical hernia

Skin Manifestations of irritable bowel disease (IBD)

 Erythema Nodosum: It causes tender, reddish lumps

usually on your shins, which look like bruises. It may start
with flu-like symptoms such as fever and aching, but it’s
most common with IBD.
 Pyoderma Gangrenosum: it begins with a small, red bump,
usually on your legs. Within hours or days, it grows into a Figure 9: Shows Erythema Nodosum
large, painful sore or ulcer.
 Acne.
 Psoriasis: red, dry, scaly, itchy skin and soreness.
 Enterocutaneos Fistulas: which is small tunnel between the
intestines and the skin; it may leak waste or pus and cause
pain or swelling.
 aphthous ulcers: also called Canker Sores, small, shallow Figure 10: Shows psoriasis

lesions that develop on

the soft tissues in the
mouth or at the base of
the gums.

Other manifestations:
Figure 11: Shows aphthous ulcers
Skin Tags, Acrodermatitis Figure 12: Shows Enterocutaneos Fistulas

Enteropathica, Pyoderma Vegetans, Leukocytoclastic Vasculitis, Clubbing, Sweet’s Syndrome.

Works Cited
Benedetti, J. (2021, 12). Skin Manifestations of Internal Disease. Retrieved from msd manuals:
https://www.msdmanuals.com/professional/dermatologic-disorders/approach-to-the-
dermatologic-patient/skin-manifestations-of-internal-disease

Labib A, Rosen J, Yosipovitch G. Skin Manifestations of Diabetes Mellitus. [Updated 2022 Apr 21]. In:
Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA):
MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK481900/

Lause M, Kamboj A, Fernandez Faith E. Dermatologic manifestations of endocrine disorders. Transl

Pediatr 2017;6(4):300-312. doi: 10.21037/tp.2017.09.08

Huang, B. L., Chandra, S., & Shih, D. Q. (2012). Skin manifestations of inflammatory bowel disease.
Frontiers in physiology, 3, 13. https://doi.org/10.3389/fphys.2012.00013