Diabetes, Metabolic Syndrome and Obesity (Dec 2020)
Clinical Significance of Diabetic Dermatopathy
Abstract
Piyu Parth Naik,1 Syed Nadir Farrukh2 1Department of Dermatology, Saudi-German Hospitals & Clinics, Dubai, United Arab Emirates; 2Department of Internal Medicine, Adam-Vital Hospital, Dubai, United Arab EmiratesCorrespondence: Piyu Parth NaikDepartment of Dermatology, Saudi-German Hospitals & Clinics, Hessa Street 331 West, Al Barsha 3, Exit 36 Sheikh Zayed Road, Opposite of American School, Dubai, United Arab EmiratesTel +971562173323Email [email protected]: Diabetic dermopathy is a cutaneous manifestation commonly seen in diabetes patients and was initially described by Melin in 1964. These lesions are well-demarcated, hyperpigmented macules or papules with atrophic depression and were commonly sighted on shins of the tibia with bilateral asymmetrical distribution and rarely seen on arms, thighs and abdomen. The incidence of DD ranges from 0.2 to 55%. It has been frequently associated with microangiopathic complications of diabetes such as nephropathy, retinopathy and polyneuropathy. Although the exact mechanism of occurrence is unknown, it may be related to impaired wound healing due to decreased blood flow, local thermal trauma or local subcutaneous nerve degeneration. Diagnosis is made by clinical examination and the differential diagnosis includes stasis dermatitis, early lesion of necrobiosis lipoidica and purpuric dermatitis. Prevention of dermopathy lesions includes optimized glucose control. No active treatment is recommended or proven effective and DD is known to resolve on its own as time passes. Modified collagen and high glycerine-based lotion have shown marked improvement in skin color changes due to diabetic dermopathy. Diabetic dermopathy is known to have a strong association with microangiopathic complications; the presence of such lesions must raise strong suspicion and prompt investigation for severe underlying pathology. Enhanced scrutinized glycemic control in diabetic dermatopathy patients can even lead to abatement in further progression to microvascular complications and improved long-term patient outcomes.Keywords: diabetic dermopathy, diabetes mellitus, pretibial patches, cutaneous lesions in diabetics, microvascular disease
