Skin Allergies in Diabetes
Allergy is a condition of hypersensitivity in certain people. Persons with allergies react to substances that are usually harmless to most individuals.
Examples of these substances are foods, medications, and chemicals (fragrances, dyes, and detergents). The symptoms of an allergic reaction will depend on where it takes place. If it occurs in the nose, it may cause sneezing and running of the nose, giving rise to hay fever. In the air passages it may cause wheezing, coughing, and difficulty in breathing, as in asthma. In the skin, it may produce itching spots, red rashes, swelling of the skin called hives or welts (urticaria), and swelling of the face (angioedema). In severe cases generalized allergic reaction may lead to shock (anaphylactic shock).
There are two main types of skin allergies: Hives and contact allergies. Hives are red, itchy swollen areas of the skin which appear in clusters. The rashes arise suddenly and leave as quickly as one or two hours or last as long as 24 hours. Hives are often triggered internally by foods or medications. Among the most common food culprits are nuts, Seafoods, food colors and food preservatives. Common medications associated with hives are antibiotics (penicillins), aspirin, analgesics (ibuprofen) and anti-seizure drugs.
Allergic contact dermatitis is a skin reaction to something that touched the skin at that site. The trigger is usually external. The rash is usually obtained from prolonged exposure to the substance. If the skin seemed to react the first time it was exposed to the agent, there was probably previous exposure without conscious knowledge. Common substances that cause allergic reactions include hair dyes or straighteners; metals (e.g., nickel) which are usually found in fancy jewelry and belt buckles; tanning agents in leather; rubber from slippers and gloves; citrus fruit peels; fragrances in soaps, shampoos, lotions, perfumes and cosmetics; and gardening products. Even topical medications applied on the skin may produce allergies. Poison ivy is also a common plant allergen.
People with diabetes mellitus are particularly prone to experiencing exaggerated manifestations of skin allergies because of inherently unfavorable skin conditions. Diabetics commonly harbor dryness of the skin leading to thickening and scaliness. They may likewise have systemic abnormalities such as sluggish blood circulations that play a role in decreasing tactile sensation and delaying wound healing in excoriated skin. Secondary bacterial infections may then set in with greater ease owing to the diminished immune response in diabetics.
In a different manner, diabetics may also be predisposed to skin allergies because of drug reactions to medications such as the sulfonylureas and even to insulin. Moreover, co-morbidities exist in diabetic patients that make it more difficult to deal with their skin conditions. The danger of eliciting drug reactions mandates judicious treatment. Systemic corticosteroids, considered as one of the mainstays in the treatment of allergies in general, are not a favorable treatment option for diabetics. All these combine to heighten the rate of complications (secondary infections, persistent rashes) in diabetic patients with skin allergies.
Dermatologists usually diagnose contact dermatitis, and other allergies from history, symptoms and physical examination. For difficult cases, skin prick or patch testing examinations are requested to determine possible causes of allergies. Routine blood examinations and x-rays usually do not help.
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