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Cutaneous Manifestations of Endocrinologic Disease

»	How does endocrinologic disease cause skin disorders?
»	What is necrobiosis lipoidica?
»	Do all patients with necrobiosis lipoidica have diabetes?
»	Is necrobiosis lipoidica diabeticorum common in patients with diabetes?
»	Does glucose control affect necrobiosis lipoidica diabeticorum?
»	What other skin findings are associated with insulin resistance?
»	What does acanthosis nigricans look like?
»	Is diabetes the only condition associated with acanthosis nigricans?
»	What bacterial infections are more common in diabetic patients?
»	What are the most common fungal skin infections associated with diabetes?
»	Are there more dangerous fungal infections associated with diabetes?
»	Why are diabetic patients in ketoacidosis especially prone to mucormycosis?
»	What other skin disorders are commonly encountered in diabetic patients?
»	Describe the clinical manifestation of pretibial myxedema.
»	Why does treatment of Graves’ disease have no effect on pretibial myxedema?
»	What are the skin manifestations of hypothyroidism?
»	Why do hypothyroid patients have yellow skin?
»	Why do hypothyroid patients have thickened skin?
»	How does the myxedema of hypothyroidism differ from pretibial myxedema of Graves’ disease?
»	Are the skin changes of hypothyroidism reversible with thyroid replacement?
»	What are the skin manifestations of hyperthyroidism?
»	Which hormone gives the skin a darkened or tanned appearance?
»	What skin disease is associated with insulin-dependent diabetes, hypothyroidism, and Addison’s disease?
»	What skin findings are associated with glucocorticoid excess or Cushing’s disease?
»	Are the skin changes caused by excess glucocorticoids reversible?
»	Which hormones have the greatest effect on sebaceous glands and hair?
»	Are there medications and nutritional supplements that may cause acne?
»	What hormonal methods are available to treat acne?
»	What are xanthelasma?
»	What are eruptive xanthomas?
»	How do eruptive xanthomas differ from tuberous xanthomas?
»	What are the cutaneous features of acromegaly?
»	How does panhypopituitarism affect the skin?
»	How do you diagnose endocrine disease from skin findings?

What bacterial infections are more common in diabetic patients?

Cutaneous bacterial infections are relatively more common and severe in patients with diabetes. Diabetic foot ulcers are a leading cause of morbidity and health care cost. Foot numbness from diabetic neuropathy prevents recognition of injury and hyperglycemia impairs white blood cell function, allowing bacterial infection. Staphylococcal folliculitis or skin abscesses are well described in diabetic patients and respond well to antibiotics and surgical drainage of abscesses. Diabetic patients may develop external necrotizing ear infections caused by Pseudomonas aeruginosa.

There is increasing evidence that diabetes mellitus is an important risk factor for tuberculosis. It also may affect disease presentation and treatment response. Additionally, evidence suggests that tuberculosis might induce glucose intolerance and worsen glycemic control in people with diabetes.

Dooley KE, Chaisson RE: Tuberculosis and diabetes mellitus: convergence of two epidemics, Lancet Infect Dis 9:737–746, 2009.