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Surgical incisions take a long time to heal in diabetic patients due to abnormal insulin levels. This is why physicians make sure sugar levels of diabetic patients are in control before surgery. There are various diabetic complications with surgery because diabetes affects different functions in human body. Recognition of seborrheic dermatitis is important for the primary care physician, because it may be associated with systemic disease, such as Parkinson's disease and human immunodeficiency virus (HIV) infection. Differential diagnosis includes psoriasis, atopic dermatitis, allergic or irritant contact dermatitis, and dermatophyte (tinea) infections. Treatment includes medicated shampoos containing zinc pyrithione, selenium sulfide, salicylic acid, coal tar, or ketoconazole in combination with topical corticosteroids. Differential diagnosis includes verruca vulgaris (warts), epidermal nevus, melanocytic nevi, and melanoma.
Differential diagnosis includes erythema multiforme, systemic lupus erythematosus (SLE), bullous pemphigoid, mastocytosis. Treatment includes elimination of known causes, antihistamines (H1 and H2 blockers), oral corticosteroids for acute flares, and, in refractory cases, immunosuppresants such as sulfasalazine and cyclosporine.
Differential diagnosis includes urticaria, bullous arthropod reaction, drug eruption, and bullous pemphigoid.
Differential diagnosis includes tinea versicolor, pityriasis alba, postinflammatory hypopigmentation, and hypopigmented mycosis fungoides. Treatment includes broad-spectrum sunscreens, potent topical corticosteroids, topical calcineurin inhibitors (tacrolimus or pimecrolimus), narrow band ultraviolet (UV) B phototherapy, psoralen with UVA (PUVA) therapy, or total depigmentation for extensive disease. The most common cause of erythema nodosum in the pediatric population is streptococcal pharyngitis. Treatment includes identifying and eliminating known causes, bed rest and elevation of the extremities, aspirin or nonsteroidal anti-inflammatory medications (NSAIDs), colchicine, and supersaturated potassium iodide. Pemphigus vulgaris can develop at any age, but it most commonly occurs in the fourth to sixth decades of life, usually in people of Mediterranean or Jewish ancestry.2 Morbidity and mortality are significant, even with treatment.
Differential diagnosis includes bullous pemphigoid, Stevens-Johnson syndrome, and epidermolysis bullosa acquisita. Treatment includes good wound care for affected skin, systemic corticosteroids, various steroid-sparing immunosuppressants, rituximab, intravenous immunoglobulin (IVIg), and plasmapheresis. Bullous pemphigoid occurs most commonly in the elderly, with an onset between 65 and 75 years of age. Differential diagnosis includes bullous SLE, epidermolysis bullosa acquisita, cicatricial pemphigoid, and dermatitis herpetiformis. Treatment includes topical and systemic corticosteroids, steroid-sparing immunosuppressants, and tetracycline in combination with niacinamide. Treatment includes topical and systemic corticosteroids, steroid-sparing immunosuppressants, colchicine, and plasmapheresis.
Differential diagnosis includes pilar or epidermal inclusion cyst, adnexal tumor, neurofibroma, and lipoma.
Differential diagnosis includes allergic or irritant contact dermatitis (especially if bilateral), psoriasis, and dermatophyte (tinea) infection.
Acanthosis nigricans can develop following the use of some medications, such as systemic corticosteroids, nicotinic acid, diethylstilbestrol, and isoniazid (INH).
Differential diagnosis includes confluent and reticulated papillomatosis of Gougerot and Carteaud and Dowling-Degos disease. Treatment for type I acanthosis nigricans includes identifying and removing the malignant tumor.
Sweet's syndrome can occur with inflammatory bowel disease, bowel bypass syndrome, and pregnancy. Differential diagnosis includes erythema multiforme, deep fungal infection, pyoderma gangrenosum, and cutaneous metastases.
Differential diagnosis includes pemphigus vulgaris, bullous pemphigoid, and erythema multiforme.
Treatment includes treatment of the underlying malignancy, systemic corticosteroids, steroid-sparing immunosuppressants, rituximab, and plasmapheresis. Erythema gyratum repens is a rare but very distinctive skin disease characterized by reddened concentric bands in a whorled or woodgrain pattern. Carney complex encompasses LAMB syndrome (lentigines, atrial myxoma, mucocutaneous myxomas, and blue nevi) and NAME syndrome (nevi, atrial myxoma, myxoid neurofibromas, and ephelides), entities known to pediatricians, cardiologists, and dermatologists. Differential diagnosis includes cutis laxa, Ehlers-Danlos syndrome, and perforating calcific elastosis. Ehlers-Danlos syndrome is a heterogeneous group of connective tissue disorders characterized by joint hyperextensibility, hypermobility, skin and vessel fragility, and fish-mouth scars. Eleven types of Ehlers-Danlos syndrome have been identified with varying associated features, including mitral valve prolapse, blue sclerae, vascular aneurysm, aortic dissection, hernias, angina, gastrointestinal bleeding (perforation), and peripheral vascular disease. Sarcoidosis is a multisystem, granulomatous disease of the lungs, bones, central nervous system, lymph nodes, eyes, and skin. Differential diagnosis includes rosacea, trichoepitheliomas, granulomatous syphilis, and granuloma annulare. Treatment includes TNF-α inhibitors, metrotrexate, NSAIDs, and steroid-sparing immunosuppressants. Lupus erythematosus is an autoimmune photosensitive dermatosis that can be localized or systemic, often with significant overlap. The cutaneous manifestations of SLE include malar erythema, photosensitivity, oral ulcers, discoid plaques, bullae, purpura, calcinosis cutis, and alopecia.
Differential diagnosis includes diabetic sclerodema, scleromyxedema, and chronic graft-versus-host disease. Treatment includes vasodilating drugs, phototherapy (UVA1) for limited disease, methotrexate, and cyclophosphamide.
Reactive arthritis (Reiter's syndrome with conjunctivitis, urethritis, and diarrhea) (Fig. Differential diagnosis includes psoriasis, juvenile plantar dermatoses, rheumatoid arthritis, ankylosing spondylitis, and gout. Treatment includes topical corticosteroids, cyclosporine, or acitretin for refractory disease. Erythema chronicum migrans, the hallmark of Lyme disease, reflecting early infection with the tick-borne spirochete Borrelia burgdorferi, develops as a red macule or papule at the site of the tick bite and gradually enlarges to an annular, reddened plaque (Fig.
Differential diagnosis includes cellulitis, spider bite, erythema multiforme, and erythema annulare centrifugum.
Diagnostic criteria include the aforementioned changes plus elevated creatine kinase or aldolase level, positive Jo-1 antibody, and electromyographic changes. Treatment includes systemic corticosteroids, methotrexate and other steroid-sparing immunosuppressants, and TNF-α inhibitors. Differential diagnosis includes linear IgA dermatosis, bullous pemphigoid, scabies, contact dermatitis, and bullous lupus erythematosus. Acrodermatitis enteropathica is an inherited or acquired condition characterized by pustules, bullae, scaling in an acral and periorificial distribution, and concomitant zinc deficiency. Differential diagnosis includes other nutritional deficiencies, such as niacin or biotin deficiency, and necrolytic migratory erythema. Necrolytic migratory erythema (glucagonoma syndrome) is a rare disease characterized by erythematous, scaly plaques on acral, intertriginous, and periorificial areas, in association with an islet cell tumor of the pancreas. Necrolytic acral erythema, characterized by pruritic keratotic plaques on the upper and lower extremities, is a distinctive finding in hepatitis C infection and can resemble a deficiency dermatosis. Gardner's syndrome is an autosomal dominant cancer syndrome characterized by colonic polyposis, osteomas (maxilla, mandible, skull), scoliosis, epidermoid cysts, and soft-tissue tumors (fibromas, desmoids, lipomas).
Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) is an autosomal dominant disorder characterized by numerous telangiectases on the skin and oral mucosa (Fig. Treatment includes estrogen therapy or oral contraceptives in postpubertal women, laser cauterization, selective embolization, and supportive care.
Muir-Torre syndrome is a disorder characterized by one or more sebaceous tumors (adenoma, epithelioma, carcinoma) and one or more internal neoplasms, usually colorectal or genitourinary, rarely lymphoma. Peutz-Jeghers syndrome is an autosomal dominant disease characterized by lentigines on the skin (periorbital region, dorsal surfaces of the fingers and toes) and mucosa (lips, buccal mucosa) and hamartomas of the stomach, small intestine, and colon. Differential diagnosis includes LEOPARD syndrome, Carney complex, and Cronkhite-Canada syndrome. Treatment includes regular and routine endoscopy and symptomatic treatment for hypogeusia and diarrhea. Pyoderma gangrenosum is a neutrophilic dermatosis characterized by painful ulcers with boggy, undermined edges and a border of gray or purple pigmentation (Fig.
Differential diagnosis includes infection, vasculitis, spider bite, and factitious disorder. Treatment includes treatment of underlying disease if applicable, local wound care, systemic and intralesional corticosteroids, cyclosporine, and infliximab. Nephrogenic systemic fibrosis, also known nephrogenic fibrosing dermopathy, is a recently described disorder that resembles scleroderma.
Treatment includes immunosuppressive agents, phototherapy, topical steroids, retinoids, and photopheresis, all with little benefit. Birt-Hogg-Dubé syndrome is a disorder characterized by multiple fibrofolliculomas and trichodiscomas (skin-colored dermal papules on the face and trunk). Porphyrias are inherited or acquired disorders of heme biosynthesis and can be erythropoietic, hepatic, or mixed in nature, each associated with a specific enzyme defect in the heme pathway.
Precipitating factors include alcohol ingestion, estrogen administration, certain hepatotoxins (dinitrochlorobenzene, carbon tetrachloride), HIV infection, hemochromatosis, and hepatitis C infection. Differential diagnosis includes bullous SLE, epidermolysis bullosa acquisita, pseudoporphyria, and variegate porphyria. Pseudoporphyria mimics porphyria cutanea tarda without an enzyme defect; plasma and urinary porphyrins are normal.
By recognizing cutaneous manifestations of systemic diseases, the internist can often determine the appropriate diagnosis and therapy or the need for referral to a dermatologist. Joly P, Benichou J , Lok C, et al: Prediction of survival for patients with bullous pemphigoid.
Kury S, Dreno B , Bezieau S, et al: Identification of SLC39A4, a gene involved in acrodermatitis enteropathica.
High WA, Ayers RA , Chandler J, et al: Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis. For severe keratosis pilaris other therapeutic options are used which include different types of lotions and creams. If your doctor prescribes emollient-based topical steroid cream to be applied on the inflamed, red rash areas, then do that once or twice a day. In case of severe keratosis pilaris, it can be treated orally using isotretinoin pills, which is generally prescribed for several months. In case of resistant keratosis pilaris, minor surgical procedures like gentle acne extractions can help more. The treatments performed by physicians in the clinic along with a home maintenance skin care routine will help in getting the best result in case of keratosis pilaris.
Armpit rashes can arise due to some product that causes skin allergy in the suffering person. The armpit is one of the warmest regions of the human body that remains covered between the trunk and the arm. In some cases, the rashes may be a sign of other conditions like diabetes, skin infections, venereal diseases and AIDS.
Medical treatment of the condition is usually done with the help of over-the-counter medicines, ointments and creams.
Aloe Vera extract works as a wonderful Underarm Rash natural remedy, especially to reduce itchiness arising from the eruptions.
Basil oil, Tree tea oil and garlic paste are some other substances that work well as Underarm Rash natural remedies.
Using antibacterial powders like Candula can prevent a bacterial infection in the skin region and help you avoid the outbreak of rashes. Applying prickly heat powders in the sweat regions like armpits, neck and groin can keep rashes at bay. The symptoms of diabetes, on skin are mostly curable, especially, if they are detected early. Due to diabetes, the smaller blood vessels supplying blood and oxygen to the skin get damaged. The diabetes leads to damaging of the blood vessels and this damage is visible in the form of different skin conditions. Other than diabetic dermopathy, damage in blood vessels can also cause Necrobiosis lipoidica diabeticorum or NLD, where large and shiny scaly patches develop over the skin. The diabetics have high sugar level in their blood, providing a perfect medium for the growth of fungus and other pathogens. This fungus mostly develops in moist and warm areas regions of the skin, like, around the fingernails, between toes, in armpits, in groin area, under foreskin of male genitalia, and also in corners of the mouth. Other fungal infections that may be found in the skin of diabetic patients, include, athlete’s foot, jock itch and ring worm. Bacterial infections are also very prominent, on the skin of diabetic patients, due to high blood sugar levels.
The most common bacterial infections found in the skin of diabetic patients, include, boils, infection of glands present in the eyelids, inflammation of a certain region of skin and tissues below it also called as carbuncles, folliculitis (infection in the hair follicles) and inflammation around the nails. Blisters are not a regular sight in the diabetic patients, but, some patients may develop blisters in their forearms, feet, toes, hands and fingers. This condition is mainly found in the patients suffering from type 1 diabetes and can be controlled by normalizing blood sugar levels. This condition of the skin is mainly found, in the males of younger age group, suffering from type 1 diabetes. Due to high glucose levels, the fluid from the skin cells evaporates, leaving the skin dry.
Diabetic patients need to take special care of their skin, and keep on sanitizing and moisturizing it, to prevent it from drying. Atherosclerosis is the thickening of arteries, and a common occurrence in diabetic patients.
In medical terms, a€?Gangrenea€? is described as death of particular organ or area of the body when blood supply is totally blocked. Dry gangrene is a case, when the area gets insufficient blood supply and the underlying tissues turn black and cold.
Apart from physical examination, your doctor will ask for history of illness to detect gangrene.
Hyperbaric oxygen is given to the patient for healing the wound and infection, but one has to monitor the symptoms and follow-up consultation for avoiding surgery.
It is a widely known fact that diabetes can lead to various other diseases due to imbalance it creates in human body. Abnormal rise or fall in blood sugar levels can have adverse consequences on patient’s health post surgery.


When our body has less insulin levels, it starts burning fat to release energy and ketones as a by product.
High blood sugar levels can result in slow healing of surgical wounds and delay suture removal.
Ischemia is caused in diabetic patients after surgery as a consequence of abnormal heart rate and rhythm. Reading about these complications is a great way to enhance your understanding and knowledge about post surgical diabetic complications.
1) is a common chronic, superficial inflammatory disease of the scalp, face (especially the eyebrows and nasolabial folds), ears, and central chest, affecting 2% to 5% of the population.
Patients who have had a cerebrovascular accident (CVA) can develop seborrheic dermatitis on the scalp in a unilateral distribution, corresponding to the affected hemisphere. Alternatively, fluconazole 400 mg (one dose) may be effective in combination with a mild topical corticosteroid. 2), the most common benign cutaneous neoplasms, are warty, age-related hyperkeratotic papules and plaques that appear anywhere on the body, most commonly the trunk.
3), or hives, is most often caused by medication (commonly penicillin or other antibiotics, sulfa drugs, aspirin) or food (shellfish, nuts, chocolate), and less often by infection. Wheals in a fixed location for more than 24 hours suggest the possibility of urticarial vasculitis and warrant a skin biopsy.
4), a cutaneous hypersensitivity reaction, is usually caused by infection (herpes simplex virus or Mycoplasma pneumoniae) and less commonly by drug sensitivity (sulfonamides, barbiturates, antibiotics).
5) is characterized by a focal or generalized distribution of depigmented macules and patches.
6), the most common type of panniculitis, is characterized by painful, erythematous nodules on the shins and occasionally elsewhere. Other infectious causes include tuberculosis, gastrointestinal (GI) infections with Yersinia, Salmonella, or Shigella, and systemic fungal infections.
7) is an uncommon chronic and debilitating blistering disease characterized by painful mucosal erosions and flaccid blisters that become erosive. 8) is the most common bullous disease and is characterized by large, tense subepidermal blisters, which are often pruritic.
Prognosis is influenced by age and general condition of the patient, not by extent of disease activity.3 Treatment of older patients in poor health requires caution.
9) is an uncommon bullous disease characterized by skin fragility, milia (small cysts), scarring alopecia, and nail dystrophy.
11) is an uncommon condition characterized by unilateral eczematous plaque of the nipple and areola. Extramammary Paget's disease affects older adults and is often associated with an underlying adnexal (apocrine) carcinoma or an underlying cancer of the genitourinary tract or distal gastrointestinal tract. Occasionally, acanthosis nigricans is a marker of an underlying adenocarcinoma, especially of the gastrointestinal tract (60% gastric).
Treatment for types II and III includes weight loss and treatment of the underlying endocrine disorder, if applicable. 13), or acute febrile neutrophilic dermatosis, has a strong association with acute myelocytic or myelomonocytic leukemia. Affected patients have papules on the eyelids and extremities that become purpuric and ecchymotic due to increased blood vessel fragility secondary to amyloid infiltration of the vessels.
15), characterized by intractable stomatitis and blisters on the trunk and extremities, has features of pemphigus and erythema multiforme. 16), an acronym for lentigines, electrocardiographic changes, ocular telorism, pulmonary stenosis, abnormal genitalia, retarded growth, and deafness.
Recognition of these syndromes is critical because identification and removal of the associated atrial myxomas may be lifesaving. 17) is characterized by yellow papules over redundant skin folds on the neck, abdomen, and groin, giving the skin the appearance of plucked chicken skin. Ehlers-Danlos syndrome is characterized by abnormalities in collagen biosynthesis, which can affect many organ systems.
Genetic testing for specific mutations has demonstrated redundancy and has reduced Ehlers-Danlos syndrome from eleven to seven types. Asymmetric fusiform swelling of the distal interphalangeal joints (sausage digits), in association with oligoarthritis and tenosynovitis can be seen in up to 70% of PsA patients. 20) is characterized by annular pink to red plaques in a sun-exposed, shawl-like distribution on the chest, back, and arms.
The localized form, known as morphea, begins as erythematous patches that evolve into dusky, hypopigmented, indurated plaques with violaceous borders, usually on the trunk. In adults, dermatomyositis has a strong association with neoplasm, usually an adenocarcinoma of the breast, gastrointestinal tract, or lung. 25) is a chronic, intensely pruritic blistering disease characterized by symmetric grouped vesicles, papules, and wheals on the elbows, knees, scalp, and buttocks. When inherited, acrodermatitis enteropathica results from a mutation in SLC39A, which encodes an intestinal zinc transporter.8 In infants, deficiency can follow breast-feeding, when maternal breast milk contains low levels of zinc. 26) associated with circulating type II cryoglobulins, usually yields palpable purpura on the lower extremities.
27) is characterized by violaceous, flat, polygonal papules, often on the flexor aspects of the wrists, trunk, medial thighs, genitalia, and oral mucosa.
This syndrome results from an inactivating germline mutation of the DNA mismatch repair genes, most often MSH-2. The polyps are usually benign with low malignant potential, but patients have a 10 to 18 times greater lifetime risk of cancer, especially GI malignancies.
Nephrogenic systemic fibrosis occurs in patients who have end-stage renal disease and are on dialysis and occasionally in patients with acute renal failure or after kidney transplantation.
Patients have a significantly increased risk of renal oncocytoma and chromophobe renal carcinoma.
Porphyria cutanea tarda, the most common porphyria, is a hepatic porphyria with acquired and sporadic forms (Fig. Manifestations of porphyria cutanea tarda include photosensitivity, skin fragility, bullae and erosions on sun-exposed skin (especially dorsal hands), and hypertrichosis. Medications (NSAIDs [especially naproxen], furosemide, and tetracycline) are the most common cause of pseudoporphyria.
Box 1 outlines the most common cutaneous manifestations of diabetes, arranged by frequency of occurrence (most to least frequent). From acute febrile neutrophilic dermatosis to neutrophilic disease: Forty years of clinical research. The general measures are taken for prevention of excessive dryness of the skin, which include soap-less cleansers like Dove, Cetaphil etc. Such lotions include lactic acid lotions (AmLactin, Lac-Hydrin), retinoic acid products like tazarotene (Tazorac), tretinoin (Retin-A), and adapalene (Differin), alpha hydroxy acid lotions such as Glytone, glycolic body lotions etc.
Combination therapy that uses physical treatment and topical emollients show better results.
The presence of these lumps are normally felt when the sufferer tries to shave the hairs of the underarm or wears tight fitting clothes. Sufferers experience a constant itching sensation which makes them scratch the underarm region for relief.
People in hot and even humid countries are, naturally, more prone to underarm rashes than those living in cold nations. Constant brushing of armpit against the dresses is often seen as a reason behind this condition. It is not uncommon to find Underarm Rash during pregnancy, particularly in the first trimester.
Vitamin E capsules are found to be effective in facilitating quick recovery from the rashes.
If the rashes are found to be caused by fungal infection, doctors may prescribe an anti-fungal cream. If you feel a particular deodorant is causing rashes in your armpit, you should stop using it. Here are some Underarm Rash photos that will help you understand about the appearance of these armpit eruptions. This increase in blood glucose can be either because of inefficiency of the body to produce insulin, or due to inefficiency of the body cells to respond to insulin.
In fact, it has been observed in studies that as much as 33% of the total population, in the world, suffering from diabetes, has to suffer from different types of skin disorders.
So, anyone having a diabetic condition should take these symptoms seriously and get them cured, as early as possible. This is caused due to hyper pigmentation and occurs mainly in the places, where the skins meet, like, neck, armpits, groin, and under the breasts.
This results into the formation of small scaly patches of reddish to brown or light brown color, over the skin. Poor circulation of blood due to damage of blood vessels also leads to itchiness and numbness of skin.
These fungal infections are characterized by the present of sore spots and rashes, which are surrounded by small blisters on all sides.
Patients having any of these symptoms of fungal infection, need to immediately rush to the doctor and get proper medications. These infections are mostly characterized by inflammation of the affected tissue, which is red in color and very painful. These blister resemble those blisters that are developed due to burns and can be of any size, from small to large. This condition is known as digital sclerosis, and it makes the joints of affected body parts (mostly fingers) stiff and incapable of normal movement. This dryness is also caused due to infection of pathogens, like, fungus, bacteria and virus.
These factors include different types of infections, dryness of the skin, and also allergies. This condition affects the legs of the patients and results into hairless, shiny, thin and cold skin.
But, thankfully, you can control these skin conditions, by using proper medication and remedies. Gangrene may occur in any part of the body but it is found more commonly in fingers, toes, feet and hands. It is common for people who have arteriosclerosis and diabetic patients and people with high cholesterol level are more prone to get dry gangrene than others. If a person has severe trauma or severe burn injury and if the wound is not healed properly, it may develop into gangrene. You can notice change in normal skin color and the area becomes purple or red initially which in turn takes deep brown color or black. If you have any symptoms of pus like discharge or swelling with pain, visit the nearest clinic immediately. A diabetic patient undergoing surgery has to be aware of surgical complications with diabetes. Let us try to understand more about surgical complications in patients who suffer from diabetes.
Sepsis means increased presence of bacteria in the blood stream due to infection caused as a result of ulcers or incisions at surgical sites.
Clinically, the disease is characterized by thin erythematous plaques, often with a fine, greasy scale. Rarely, seborrheic keratoses indicate an underlying adenocarcinoma of the gastrointestinal tract if they appear suddenly in great numbers (sign of Leser-Trélat). Chronic idiopathic urticaria for which no trigger can be identified often requires further testing such as serum radioallergosorbent testing (RAST) or skin prick-patch testing. Erythema nodosum occurs most commonly in young women, with a peak incidence between 20 and 40 years.1 In addition to the cutaneous findings, patients can have fever, malaise, arthralgias, or arthritis.
Less common causes include drug sensitivity (sulfonamides, salicylates, iodides, oral contraceptives or hormone replacement therapy), and a variety of systemic diseases, most often inflammatory bowel disease (Crohn's disease more than ulcerative colitis) and sarcoidosis.
Skin disease typically follows trauma and occurs primarily on the hands, feet, elbows, and knees. Malignant acanthosis nigricans has a sudden onset and more extensive distribution, including the face, palms, and trunk. Topical treatments including tretinoin, calcipotriol, urea, and salicylic acid may be helpful. Affected patients, usually middle-aged women, have painful erythematous to violaceous plaques on the face, extremities, and trunk.
Direct immunofluorescence reveals deposition of IgG intercellularly and at the dermal-epidermal junction.
Erythema gyratum repens has a strong association with lung cancer; the association with breast, cervical, and gastrointestinal cancers is less strong. Pseudoxanthoma elasticum represents a defect in elastic fibers, which become brittle and calcified.
Patients with vascular (type IV) Ehlers-Danlos syndrome are prone to arterial rupture and have the highest mortality.
Skin disease, affecting 25% to 35% of patients, includes red to purple indurated plaques of the nose (lupus pernio) (Fig. Other presentations include symmetric polyarticular arthritis (15%), distal interphalangeal joint disease with nail damage (16%), arthritis mutilans with erosion of the phalanges (5%), and ankylosing spondylitis (5%).
19), usually localized to the head or neck, is characterized by atrophic, scarring plaques on sun-exposed areas. The systemic or generalized forms are subdivided into CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias) and progressive systemic sclerosis.
Implicated organisms include Campylobacter, Shigella, Salmonella, Ureaplasma, and Yersinia species.
Affected patients can have fever, arthralgia, and myalgia, and, occasionally, Bell's palsy. Biopsy reveals a characteristic neutrophilic infiltrate, and direct immunofluorescence demonstrates deposition of IgA at the dermal-epidermal junction. Lichen planus also occurs with primary biliary cirrhosis and hepatitis B virus immunization.
Recurrent epistaxis is the most common presenting manifestation of the syndrome, affecting approximately 85% to 90% of patients.
The ulcers often follow trauma (pathergy) and begin as pustules or nodules that ulcerate and extend centrifugally.9 All body areas may be involved, but the legs are the most common site.
Nephrogenic systemic fibrosis is characterized by thick, indurated plaques on the extremities and the trunk. Creams used in the treatment include urea cream like Carmol 10, Carmol 40, Carmol 20, Urix 40), salicylic acid (Salex lotion), and topical steroid creams such astriamcinolone 0.1%, Locoid Lipocream etc.
In case of inflaming skin, bland moisturisers should only be used until the inflammation is gone.


In case of persistent skin discolouration known as hyperpigmentation, fading creams are used for its treatment. The physical treatments may include microdermabrasion, mineral extraction of whiteheads and chemical peels. Tight apparels cause a friction between clothes and Underarm Rash and pain arises as a result. In some cases, the patient is also asked about his or her lifestyle, use of any allergen or the clothes that he or she wears. Anti-itching creams and underarm rash ointments are used to give patients relief from itching sensation. The skin related symptoms of diabetes may also act as warning signals, to help patients become aware of their fluctuating blood sugar levels. These blisters are mostly painless and develop, when major fluctuations occur in the blood sugar levels of the patient. Allergies surface in the form of itching, in diabetic patients, and other skin conditions also normally lead to itching. Also, as you may have noticed, many skin conditions are result of temporary sugar imbalance, so, if you are diabetic and want to avoid such uncomfortable conditions, try to keep your sugar in control. People with diabeticsa€™ mellitus and Raynauda€™s disease have increased risk of getting gangrene. Blood transfusion sites and surgical wounds become primary sites for bacterial activity in most cases.
Vitiligo commonly occurs in periorificial areas (mouth, orbits, vagina, anus) or at sites of trauma (hands, elbows, knees).
Biopsy reveals characteristic suprabasilar acantholysis and intraepidermal bullae formation. Immunofluorescence is similar to bullous pemphigoid, with IgG deposition at the dermal-epidermal junction. Skin biopsy reveals swollen, fragmented elastic fibers, and fundoscopic examination reveals angioid streaks in Bruch's membrane. 18), midfacial papules, annular plaques, and plaques or nodules on the trunk and extremities. Presence of anticentromere antibodies correlates with CREST syndrome; SCL-70 antibodies correlate with progressive systemic sclerosis. Affected patients, usually men, often have vesicles and crusted plaques on the penis (circinate balanitis) and erythematous pustules and papules on the palms and soles (keratoderma blennorrhagicum) that can mimic pustular psoriasis. Most patients have an asymptomatic gluten-sensitive enteropathy or, less commonly, thyroid disease.
Oral erosive lichen planus is the most common expression of lichen planus in hepatitis C patients.
Telangiectases can involve the lungs, liver, brain, eyes, and gastrointestinal tract; hemorrhage can occur at any site. Fifty percent of patients have underlying rheumatoid arthritis or inflammatory bowel disease or, less often, a paraproteinemia, usually an IgA gammopathy. It is caused by a deficiency in uroporphyrinogen decarboxylase, leading to the accumulation of uroporphyrin in the urine and serum.
Direct immunofluorescence reveals IgG and C3 at the dermal-epidermal junction and in vessel walls. If the patients follow a regular skincare program, they often have good temporary improvements. Sometimes, the doctor may also prescribe compound creams that contain multiple different ingredients. After the inflammation is remitted, the residual dry, rough bumps can be healed using a compound preparation that includes 2-3% salicylic acid in 20% urea cream. But in some cases they may be a symptom of some other dreadful condition which may even result in death. Questioning the patient helps the doctor form an idea about the possible causes of the appearance of the rashes. If you or anyone in your family is having underarm rashes, it is best to get medical treatment as early as possible. They neither itch, not cause irritation, and therefore, they do not demand medical treatment also. These bumps cause itching, and mostly appear on skin of the feet, back of the hand, arms, buttocks and legs.
For collecting more information, CT scan or MRI scan is done to assess the exact damage to the organ. Sepsis caused due to diabetes is a critical condition and takes a lot of time to get under control after surgery. The disorder is often associated with autoimmune thyroid disease, insulin-dependent diabetes mellitus, pernicious anemia, or Addison's disease. Direct immunofluorescence reveals a chicken-wire pattern of deposition of immunoglobulin (Ig) G within the epidermis.
Direct immunofluorescence reveals a linear deposition of IgG at the dermal-epidermal junction. Associated signs of pseudoxanthoma elasticum include hypertension, peripheral vascular and coronary artery disease, retinal and gastrointestinal hemorrhage, and stroke.
More than 50% of patients have sacroiliitis, correlating with the presence of HLA-B27 antigen, but few patients have the classic triad of urethritis, conjunctivitis, and arthritis. Primary endemic areas in the United States are New England, the upper Midwest, and the Pacific Northwest. Approximately 70% of patients have circulating IgA antibodies against the smooth muscle cell endomysium (antiendomysial antibodies), which are somewhat peculiar to dermatitis herpetiformis. Treatment includes topical and intralesional corticosteroids, topical immunomodulators, and phototherapy. Autopsies have demonstrated that disease is not limited to the skin; visceral organ and muscle fibrosis has been noted. However, care should be taken as high concentration of hydroquinone can cause irritation of the skin. For treatment of underarm rash creams and ointments are generally used more than oral medicines. Similarly, people with weakened immunity (HIV or Aids) have more chance of getting gangrene. The trachea (windpipe) conducts inhaled air into the lungs through its tubular branches, called bronchi. Loss of optimum level of water after surgery can further complicate cardiac function resulting in rapid heart rate.
Erythema nodosum, an acute, painful panniculitis that usually affects the shins, is the most common nonspecific cutaneous manifestation of sarcoidosis.
In rare cases, if the infection spreads to other parts, amputation of the part is done for preventing further damage. If you are diabetic, you need to take extra care not to get any wounds in your hands or feet and check your blood sugar level frequently. The bronchi then divide into smaller and smaller branches (bronchioles), finally becoming microscopic.The bronchioles eventually end in clusters of microscopic air sacs called alveoli. This is the why ischemic episodes are closely monitored in diabetic patients after surgery. In case of gas gangrene, the person may get fever, rapid heartbeat, and intense pain in the affected part. Carbon dioxide, a waste product of metabolism, travels from the blood to the alveoli, where it can be exhaled.
Between the alveoli is a thin layer of cells called the interstitium, which contains blood vessels and cells that help support the alveoli.The lungs are covered by a thin tissue layer called the pleura. A small amount of fluid between these two layers acts as a lubricant allowing the lungs to slide smoothly as they expand and contract with each breath.Lung conditionsChronic obstructive pulmonary disease (COPD).
The fragile walls between the lungs' air sacs (alveoli) are damaged, trapping air in the lungs and making breathing difficult.Chronic bronchitis. The lungs' airways (bronchi) become inflamed and can spasm, causing shortness of breath and wheezing. Allergies, viral infections or air pollution often trigger asthma symptoms.Acute bronchitis. The interstitium (walls between air sacs) become scarred, making the lungs stiff and causing shortness of breath.Sarcoidosis (Boeck’s disease). Tiny areas of inflammation can affect all organs in the body, with the lungs involved most of the time.
Fluid builds up in the normally tiny space between the lung and the inside of the chest wall (the pleural space). Inflammation of the lining of the lung (pleura), which often causes pain when breathing in. Autoimmune conditions, infections or a pulmonary embolism may cause pleurisy.Bronchiectasis.
The airways (bronchi) become inflamed and expand abnormally, usually after repeated infections. Coughing, with large amounts of mucus, is the main symptom of bronchiectasis.Lymphangioleiomyomatosis (LAM).
A rare condition in which cysts form throughout the lungs, causing breathing problems similar to emphysema. The excess mucus causes repeated episodes of bronchitis and pneumonia throughout life.Interstitial lung disease.
A collection of conditions in which the interstitium (lining between the air sacs) becomes diseased. Fibrosis (scarring) of the interstitium eventually results, if the process can't be stopped.Lung cancer. A slowly progressive disease that affects the lungs caused by the bacteria Mycobacterium tuberculosis.
Chronic cough, fever, weight loss and night sweats are common symptoms of tuberculosis.Acute respiratory distress syndrome (ARDS). Life support with mechanical ventilation is usually needed to survive until the lungs recover.Fungal pneumonia. Pneumonia caused by a type of fungus such as Coccidioides orHistoplasma capsulatum, both types of fungi are found in soil and can affect travellers to the USA where Coccidioides is found in the southwest, and Histoplasmosis in the eastern and central regions.
Most people experience no symptoms or a flu-like illness with complete recovery.Hypersensitivity pneumonitis (allergic alveolitis).
Usually this occurs in farmers or others who work with dried, dusty plant material.Influenza (flu).
An infection by one or more flu viruses causes fever, body aches and coughing lasting a week or more.
Influenza can progress to life-threatening pneumonia, especially in older people with medical problems.Mesothelioma.
A rare form of cancer that forms from the cells lining various organs of the body with the lungs being the most common.
Mesothelioma tends to emerge several decades after asbestos exposure.Pertussis (whooping cough).
A highly contagious infection of the airways (bronchi) by Bordetella pertussis, causing persistent cough. Many conditions can lead to high blood pressure in the arteries leading from the heart to the lungs. If no cause can be identified, the condition is called idiopathic pulmonary arterial hypertension.Pulmonary embolism. A blood clot (usually from a vein in the leg) may break off and travel to the heart, which pumps the clot (embolus) into the lungs. Sudden shortness of breath is the most common symptom of a pulmonary embolism.Severe acute respiratory syndrome (SARS). A severe pneumonia caused by a specific virus first discovered in Asia in 2002.Pneumothorax. Air in the chest; it occurs when air enters the area around the lung (the pleural space) abnormally. A CT scan uses X-rays and a computer to make detailed pictures of the lungs and nearby structures.Pulmonary function tests (PFTs). Lung capacity, the ability to exhale forcefully and the ability to transfer air between the lungs and blood are usually tested.Spirometry. Culturing mucus coughed up from the lungs can sometimes identify the organism responsible for a pneumonia or bronchitis.Sputum cytology. Viewing sputum under a microscope for abnormal cells can help diagnose lung cancer and other conditions.Lung biopsy. Examining the biopsied tissue under a microscope can help diagnose lung conditions.Flexible bronchoscopy. An endoscope (flexible tube with a lighted camera on its end) is passed through the nose or mouth into the airways (bronchi).
Rigid bronchoscopy is often more effective than flexible bronchoscopy, but it requires general anaesthesia.Magnetic resonance imaging (MRI scan). An MRI scanner uses radio waves in a magnetic field to create high-resolution images of structures inside the chest.Lung treatmentsThoracotomy. Thoracotomy may be done to treat some serious lung conditions or to obtain a lung biopsy.Video-assisted thorascopic surgery (VATS). Less-invasive chest wall surgery using an endoscope (flexible tube with a camera on its end). A tube is inserted through an incision in the chest wall in order to drain fluid or air from around the lung.Pleurocentesis.
When used soon after flu symptoms start, antiviral medicines can reduce the severity of influenza. This can reduce wheezing and shortness of breath in people with asthma or COPD.Corticosteriods. Steroids can also be used to treat less common lung conditions caused by inflammation.Mechanical ventilation.
People with severe attacks of lung disease may require a machine called a ventilator to assist breathing. The ventilator pumps in air through a tube inserted into the mouth or the neck.Continuous positive airway pressure (CPAP).
It is used at night to treat sleep apnoea, but it is also helpful for some people with COPD.Lung transplant.
Severe COPD, pulmonary hypertension and pulmonary fibrosis are sometimes treated with lung transplant.Lung resection.



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18.06.2015 Diabetes Cures


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