Diabetic dermopathy

Abstract

Diabetic 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.