AbstractDiabetic dermopathy is a term used to describe the small, round, brown atrophic skin lesions that occur on the shins of patients with diabetes. The lesions are asymptomatic and occur in up to 55% of patients with diabetes, but incidence varies between different reports. Diabetic dermopathy is more common in older patients and those with longstanding diabetes. It is associated with other microvascular complications of diabetes such as retinopathy, nephropathy and neuropathy and also with large vessel disease. Histological changes include epidermal atrophy with flattening of the rete ridges, dermal fibroblastic proliferation, altered collagen, dermal oedema and an increase in dermal capillaries, with a perivascular inflammatory infiltrate, changes to the vessel walls and melanin and haemosiderin deposition. The underlying mechanism for diabetic dermopathy is unknown, although it may be related to local thermal trauma, decreased blood flow causing impaired wound healing or local subcutaneous nerve degeneration. Diabetic dermopathy requires no treatment, but may be a surrogate for more serious complications of diabetes, which require investigation and management.
Melin H. An atrophic circumscribed skin lesion in the lower extremities of diabetics. Acta Med Scand 1964;176(Suppl.423):9-75.
Binkley GW. Dermopathy in the diabetic syndrome. Arch Dermatol 1965;92:625-34. http://dx.doi.org/10.1001/archderm.1965.01600180017003
Bauer MF, Levan NE, Frankel A, Bach J. Pigmented pretibial patches. A cutaneous manifestation of diabetes mellitus. Arch Dermatol 1966;93:282-6. http://dx.doi.org/10.1001/archderm.1966.01600210018003
Danowski TS, Sabeh G, Sarver ME et al. Shin spots and diabetes mellitus. Am J Med Sci 1966;251:570-5. http://dx.doi.org/10.1097/00000441-196605000-00011
Murphy RA. Skin lesions in diabetic patients: The "spotted-leg" syndrome. Lahey Clin Found Bull 1965;14:10-4.
Bauer M, Levan NE. Diabetic dermangiopathy. A spectrum including pigmented pretibial patches and necrobiosis lipoidica diabeticorum. Br J Dermatol 1970;83:528-35. http://dx.doi.org/10.1111/j.1365-2133.1970.tb15736.x
Ngo BT, Hayes KD, DiMiao DJ, et al. Manifestations of cutaneous diabetic microangiopathy. Am J Clin Dermatol 2005;6:225-37. http://dx.doi.org/10.2165/00128071-200506040-00003
Mahajan S, Koranne RV, Sharma SK. Cutaneous manifestation of diabetes mellitus. Indian J Dermatol Venereol Leprol 2003;69:105-08.
Goyal A, Raina S, Kaushal SS et al. Pattern of cutaneous manifestations in diabetes mellitus. Indian J Dermatol 2010;55:39-41. http://dx.doi.org/10.4103/0019-5154.60349
Ragunatha S, Anitha B, Inamadar AC, et al. Cutaneous disorders in 500 diabetic patients attending diabetic clinic. Indian J Dermatol 2011; 56:160-4.
Timshina DK, Thappa DM, Agrawal A. A clinical study of dermatoses in diabetes to establish its markers. Indian J Dermatol 2012;57:20-5. http://dx.doi.org/10.4103/0019-5154.92671
Morgan AJ, Schwartz RA. Diabetic dermopathy: A subtle sign with grave implications. J Am Acad Dermatol 2008;58:447-51. http://dx.doi.org/10.1016/j.jaad.2007.11.013
Shemer A, Bergman R, Linn S, et al. Diabetic dermopathy and internal complications in diabetes mellitus. Int J Dermatol 1998;37:113-15. http://dx.doi.org/10.1046/j.1365-4362.1998.00273.x
Romano G, Moretti G, Di Benedetto A, et al. Skin lesions in diabetes mellitus: prevalence and clinical correlations. Diabetes Res Clin Pract 1998;39:101-06. http://dx.doi.org/10.1016/S0168-8227(97)00119-8
Port M. Diabetic dermopathy: a controversy in dermatology. J Am Podiatry Assoc 1982;72:418-23. http://dx.doi.org/10.7547/87507315-72-8-418
Lithner F. Cutaneous reactions of the extremities of diabetics to local thermal trauma. Acta Med Scand 1975;198:319-25.
Abdollahi A, Daneshpazhooh M, Amirchaghmaghi E, et al. Dermopathy and retinopathy in diabetes: is there an association? Dermatology 2007;214:133-6.
McCash S, Emanuel PO. Defining diabetic dermopathy. J Dermatol 2011;38:988-92. http://dx.doi.org/10.1111/j.1346-8138.2011.01251.x
Fisher ER, Danowski TS. Histologic, histochemical, and electron microscopic features of the shin spots of diabetes mellitus. Am J Clin Pathol 1968;50:547-54.
Wigington G, Ngo B, Rendell M. Skin blood flow in diabetic dermopathy. Arch Dermatol 2004;140:1248-50. http://dx.doi.org/10.1001/archderm.140.10.1248
Brugler A, Thompson S, Turner S, Ngo B, Rendell M. Skin blood flow abnormalities in diabetic dermopathy. J Am Acad Dermatol 2011;65:559-63. http://dx.doi.org/10.1016/j.jaad.2010.06.010
Kiziltan ME, Benbir G, Akalin MA. Is diabetic dermopathy a sign for severe neuropathy in patients with diabetes mellitus? Nerve conduction studies and symptom analysis. Clin Neurophysiol 2006;117:1862-9. http://dx.doi.org/10.1016/j.clinph.2006.05.007
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