Diabetes Skin Manifestations: Acanthosis Nigricans and Necrobiosis Lipoidica – Diabetes Complications

00:01 The skin manifestations that you would find… underneath the armpit here, we have darkening.

00:07 This is called thickening of your keratinocytes which then appears dark.

00:12 That is the dissection of the term that I’ve given you called Acanthosis nigricans.

00:17 Usually, this is due to, well, research is showing us that evidence that insulin early on in type II diabetic may actually result in such manifestations, maybe the back of the neck as well and the inguinal region.

00:32 Associated with insulin resistance, sometimes seen with underlying malignancy even perhaps acanthosis nigricans.

00:40 Another skin manifestation that you would expect to find is called necrobiosis lipoidica and what this means is that around the area of the skin where it’s being damaged because of lack of blood supply and such, that you would find oval, irregular, indurated with central atrophy and yellow pigmentation referring to your lipid that you might find with red-brown margins.

01:06 There is necrosis that’s taking place locally with deposition of lipid known as necrobiosis lipoidica.

01:13 Uncommon but could be seen with patients with pre-diabetes or diabetes.

01:18 Obviously, this has nothing to do with acanthosis nigricans.

01:22 Often asymptomatic, usually that’s found on the shin.

01:26 The way that you would treat this is not very effective, but you still would have to give topical steroids.

01:32 For ulcers, you’re worried about, once again, the development of gangrene and perhaps the risk of amputation therefore cyclosporine, oxygen and maybe anti-TNF therapy with infliximab, steroids and other therapies.

01:48 There’s a wide list here, at least be able to, at this point, identify necrobiosis lipoidica that-that could be a rare complication, but still quite relevant to any case that you are going to be looking at.