Diabetic Vasculopathy

Cutaneous manifestations develop in approximately 30% of persons with diabetes. Premature atherosclerosis is a common complication of the disease that can cause peripheral infarction, ulceration, and necrosis.

As seen here on the finger of a 64-year-old man who has a 25-year history of diabetes mellitus, ulceration secondary to insensible trauma can arise from diabetic neuropathy. Healing of such a lesion may be further complicated by vascular insufficiency related to the disease.

The pathogenic mechanism of vascular disease in diabetes is not clearly understood. Early diagnosis and tight glucose control afford the best opportunity to delay disease progression.

This patient was referred to a vascular surgeon for evaluation and treatment.