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Słów kilka o skórze diabetyka PDF Drukuj Email
04.03.2010.
 

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Gdy na skórze osób chorujących na cukrzycę pojawiają się jakieś zmiany, wymaga to zawsze konsultacji u lekarza dermatologa. Jest to też sygnał dla diabetyka lub jego otoczenia, że poziom glukozy jest zbyt wysoki lub, że cukrzyca jest niewyrównana.

 

Zazwyczaj cukrzyca kojarzy nam się ze zmianami w narządach, do których dochodzi latami na przestrzeni trwania choroby. Bardzo istotne w tej chorobie są również zmiany skórne, które czasami wręcz poprzedzają pojawienie się choroby. Skóra diabetyka jest bardzo wrażliwa. Nie wolno więc lekceważyć pojawiających się na niej zmian.

Skóra diabetyków jest bardzo sucha i swędząca, a zatem skłonna do podrażnień. Bardzo łatwo więc o zakażenia o różnej etiologii. Chorzy dotknięci cukrzycą powinni wyjątkowo dbać o higienę, a także stosować środki zapobiegające nadmiernemu poceniu oraz delikatne preparaty zmiękczające do skóry, bo skóra sucha swędzi i się łuszczy, a od tego już tylko jeden krok do podrażnienia naskórka i infekcji.

Najczęściej występującym problemem dermatologicznym jest silny i uporczywy świąd skóry. Świąd ten często jest nawracający i najczęściej zlokalizowany jest w miejscach dla nas intymnych. Świąd może na wiele miesięcy wyprzedzać właściwe rozpoznanie cukrzycy, a spowodowany może być pojawiającym się i znacznie przekraczającym normę poziomem glukozy w moczu, co prowokuje z kolei wtórne infekcje drożdżakowe. Konsekwencją mogą być wyprzeniai ropne wykwity w postaci czyraków w pachwinach, na pośladkach i w okolichach narządów płciowych.

 

 

Często również wystepują nawracające drobne wybroczynki krwawe tzw. plamice naczyniowe, na całej powierzchni skóry świadczące o nadmiernej kruchości i przepuszczalności naczyń włosowatych. U osób starszych, długo chorujących na cukrzycę, można zaobserwować samoistnie tworzące się i znikające pęcherze na nogach.

Innnymi jeszcze zmianami są zniekształcenia i przebarwienia płytek paznokciowych, do których dochodzi na skutek zmian degeneracyjnych w mikrokrążeniu, czyli w drobnych tętniczkach i naczyniach włosowatych paliczków rąk i stóp. Płytki zaczynają być matowe, tracą swój połysk, zaczynają się kruszyć i ulegają znacznym deformacją. Wyglądają tak jakby pacjent od lat chorował na grzybicę płytek paznokciowych.

 

Zdarzają się także, zwłaszcza u ludzi młodych, trudno gojące się wykwity barwy woskowo-żółtej z zanikami w części centralnej na skórze powierzchni podudzi. Sprawia to wrażenie jakby młody człowiek ulegał wielokrotnie silnym urazom kończyn i miał po nich mnóstwo widocznych blizn.

Do zmian skórnych wystepujących u diabetyków zaliczyć możemy: ziarniniaki obrączkowe, zespół rzekomotwardzinowy, rumieniec cukrzycowy, rogowacenie ciemne, obrzęk stwardniały i oczywiście stopę cukrzycową.

Ziarniniaki obrączkowate
to bardzo nieestetycznie wyglądające drobne, twarde grudki układające się obrączkowato w różnych miejscach na ciele. Mają one jednak tendencje do samoistnego ustępowania bez pozostawienia blizn na skórze.

Zespół rzekomotwardzinowy jest zespołem objawów polegających na stwardnieniu i zesztywnieniu skóry palców rąk i ramion prowadzący do deformacji i upośledzenia ruchomości palców podobnie jak w chorobach reumatycznych.

Z kolei rumieniec cukrzycowy dotyczy zwłaszcza młodych osób z niewyrównaną, trwającą długo cukrzycą. Jest niestety trwały, co oznacza, że nie cofa się po zastosowanym leczeniu. Schorzenie to polega na występowaniu nieostro odgraniczonych rumieni na skórze dłoni, stóp i twarzy.

W rogowaceniu ciemnym wykwity skórne wyglądają jak ciemne małe grudki o aksamitnej powierzchni pod pachami, w pachwinach i na bocznych częściach tułowia, w okolicach pępka. Jest to przerost naskórka spowodowany wpływem czynników wzrostowych stymulowanych przez okresowe nadmierne poziomy insuliny w cukrzycy insulinoopornej.

Natomiast obrzęk stwardniały to deformacja i gromadzenie się nadmiernej ilości kolagenu i glikozaminoglikanów w tkance podskórnej w przebiegu ciężkiej cukrzycy. Zmiany polegają na stwardnieniach skóry karku, twarzy, ramion i klatki piersiowej.

W przypadku zauważenia u siebie nietypowych zmian skórnych należy zawsze skorzystać z porady dermatologicznej.

Stopa cukrzycowa jest jednym z najpoważniejszych powikłań cukrzycowych. Jest to drastyczne pogorszenie ukrwienia w obrębie stopy, które prowadzi poprzez zarastanie tętnic i uszkodzenie naczyń stopy do jej owrzodzenia, martwicy. Często moze się zakończyć amputacją palców lub nawet całej stopy. W przypadku stopy cukrzycowej zalecana jest konsultacja u lekarza chirurga.


W cukrzycy zdarzają się też częste, przewlekłe i nawracające infekcje bakteryjne, grzybicze i wirusowe.
Chorzy na cukrzycę mają zmniejszoną odporność i są bardziej podatni na wszelkie infekcje, bo ich podwyższony poziom glukozy we krwi stanowi świetne podłoże i pożywkę dla każdego rodzaju bakterii, wirusów i grzybów. Infekcje te wydają się czasami banalne, nie można ich jednak lekceważyć bo ich nawroty są niezwykle częste i uciążliwe, a infekcje z czasem stają się coraz bardziej oporne na leczenie.


Spośród wszystkich spustoszeń jakie czyni w organiźmie cukrzyca zmiany skórne są najbardziej zauważalne. Jest to wyraźny sygnał dla osoby chorującej na cukrzycę, że organizm daje wyraźne sygnały, że coś jest nie tak.  Zazwyczaj trzeba solidnie zabrać się za przestrzeganie diety i odwiedzić lekarza.

 

 

   
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