2 - Derm - Skin + Systemic disease - Diabetes and the skin

Question 1

Granuloma annulare

-describe appearance

Answer 1

smooth, annular plaques with depressed centre

• small grouped papules
• pinkish/mauve
• up to 5cm diameter

Question 2

Granuloma annulare

• who?
• where?

Answer 2

common in children and young adults
often extremities but spares plantar/palmar surface
commonly over bony prominences

Question 3

Granuloma annulare
-Sx?
mgmt?

Answer 3

usually aSx - may be tender

mgmt - usually resolves spontaneously in months - topical steroids may help persistent cases

Question 4

Diabetic dermopathy

-describe

Answer 4

small patches, round-oval, light brown to reddish, initially scaly, later become atrophic

Question 5

Diabetic dermopathy

• where?
• when?
• who?

Answer 5

typically bilateraly, asymmetrical, shins
commonly follow trauma
more common in males
-in 30% of DM pts

Question 6

Diabetic dermopathy
-more common in who?
mgmt?

Answer 6

(men)
diabetics with poor control, and with other microvascular complications
mgmt - no tx needed

Question 7

Necrobiosis lipoidica

-describe

Answer 7

larger and fewer than dermopathy
yellow-brown waxy plaques surrounded by erythema
central atrophy and telangiectasia

Question 8

Necrobiosis lipoidica
-where?
complications?

Answer 8

usually shins, medial malleolus, dorsum of foot

can ulcerate in minor injury, and risk of secondary infection

Question 9

Necrobiosis lipoidica

• common in who?
• mgmt?

Answer 9

more common in diabetic women

mgmt - top steroids may help severe/persistent cases

Question 10

What 4 other manifestations of diabetes may affect skin

Answer 10

diabetic ulcers
xanthomata (hypercholesterolaemia)
acanthosis nigricans
infections