Photoessay: The Skin and Diabetes Mellitus
by A Huntley
Dermatology Online Journal, December 1995
Volume 1, Number
2
Spontaneous Blisters in Diabetes
A small percentage of persons with diabetes mellitus have been noted to
develop
spontaneous blistering, especially on the feet and legs. These lesions
usually
heal well without treatment, but lesions may rupture, develop an ulcer
or become
secondarily infected.
-
Figs 54-56. Legs of three patients with diabetes mellitus each of
whom
developed spontaneous blistering. The left image demonstrates an
intact blister
on non-inflamed skin. The middle image shows a spontaneous blister
with one
crusted area. The right-hand image is of an ulcer and cellulitis that
developed
as a complication of a ruptured diabetic blister.
When these blisters occur on the feet, they may resemble friction
blisters,
however there is usually absence of trauma.
-
Figs 57,58. Two images of the sole of a patient with diabetes
mellitus
demonstrating a spontaneous blister. The blister developed during the
patients
hospitalization for medical problems. Culture and smears of blister
material
were negative. The lesion resolved without treatment.
Decreased threshold to trauma may play a role in the development of
blisters.
Some patients with this condition have been demonstrated to have
decreased
threshold to suction blister formation and occasionally the pressure
resulting
from edema of cardiac failure is enough to result in blisters.
-
Figs 59,60. Two views of the leg of a patient with diabetes mellitus
demonstrating spontaneous blistering and fragile skin. The left-hand
image
demonstrates a typical spontaneous blister occurring on non-inflammed
skin of
the leg. The patient returned for re-evaluation one week later and
when the
adhesive tape was removed to inspect the blister, a new erosion was
created.
All contents copyright (C), 1995.
Dermatology Online Journal
University of California Davis
