Objective: to study the relationship of factors of endothelial dysfunction and inflammatory process in the skin in patients with various forms of diabetes. Material and methods: The work is based on the analysis of skin biopsies in 64 patients, including 29 patients with SSD and 35 patients with LSD, and 20 healthy volunteers aged 16 to 60 years. Duration of the diabetes in patients was from 6 to 20 years (13.5 ± 5.2 years). Diagnosis of diabetes was verified using diagnostic criteria proposed by A.G. Guseva. Bioptates in patients with diabetes were taken with the affected and unaffected pathological process of the skin. In healthy volunteers, the skin for examination was taken with surgical correction of cosmetic defects. In the supernatant, the concentration of CRP, TNF-α, endothelin-1 (ET-1) was determined by the enzyme immunoassay, NO level, endothelial nitric oxide synthase (eNOS) activity, inducible nitroxide synthase (iNOS). The data was processed using the “SPSS for Windows” software using the method of comparative correlation and One-Way ANOVA analyzes using the Dunnett test for multiple comparison. The results for P <0.05 were considered reliable. Results: In patients with diabetes, depending on the form of the disease in the biopsy supernatant, a different level of concentration of hsCRP and TNF-α, the content of NO, ONO2-, the activity of eNOS and iNOS is determined. These systems are interrelated. In patients with SSD, the concentration of hsCRP and TNF-α, as well as disturbances in the parameters of the NO-producing skin function, are statistically significantly higher, compared with patients with OSD. Conclusions: hsCRP and TNF-α stimulate the expression of iNOS, which in turn increases the production of NO and ONO2-, inhibits the activity of eNOS, determining the peculiarity of pathomorphological changes in the skin and the shape of diabetes.