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Diabetic Dermopathy: Causes, Symptoms & Treatment

Diabetes is a condition in which the body's ability to produce or respond to insulin is impaired. This results in abnormal metabolism of carbohydrates and causes the glucose levels in the blood to spike up [1] . Diabetes is associated with several signs and symptoms, such as increased urination, extreme fatigue, etc. One condition that quite a number of diabetics suffer from is diabetic dermopathy [2] . This is a skin condition that is usually found on the lower legs. Up to 50 per cent of diabetics have a chance of being affected by this condition. Read on to know more about diabetic dermopathy, its causes, symptoms and treatment.

What Is Diabetic Dermopathy?

Diabetic dermopathy (also known as shin spots or pigmented pretibial patches) is a condition that is quite common among diabetics. It is a skin condition that is characterized by round, shiny lesions. These lesions are light brown to red in colour. They are usually found on the lower legs of people with diabetes [3] .

Doctors say that the condition occurs when there is a minor leakage of blood from these blood vessels into the skin [4] . These patches are usually not painful but can sometimes cause a burning sensation or itching. Although, there is no specific time when it occurs, in most of the cases it has been observed when there has been some kind of trauma or injury.

Contrary to what is believed by many, diabetic dermopathy is not a rare condition. Up to a third of people with diabetes has diabetic dermopathy [5] . It is known as shin spots commonly (this is due to its location).

Causes Of Diabetic Dermopathy

Although the exact cause of this condition has not been proven through clinical trials, it is believed by medical experts that this condition is caused due to damages to the nerves and blood vessels in a diabetic patient.

There is a possibility that this condition is linked to other conditions that might arise when a person has diabetes, such as diabetic neuropathy, diabetic nephropathy and diabetic retinopathy [6] .

It affects both people with insulin-dependent diabetes mellitus as well as those with non-insulin dependent diabetes mellitus.

The following individuals hold a higher risk of facing this condition [7] :

  • People who have diabetes for a minimum of 10 years
  • Older diabetic patients
  • Diabetic patients with high haemoglobin A1c level
  • People with uncontrolled diabetes
  • People who have suffered trauma or injury to the bony parts of the shins

People with diabetes are usually prone to skin problems. This is because a high blood sugar level makes the body lose fluids and get dry [8] . Skin that is dry can get cracked easily. If dry skin is left unmanaged, then it could cause itchy skin. Itchy skin, in turn, is highly susceptible to various kinds of infections.

Signs And Symptoms Of Diabetic Dermopathy [9]

  • Lesions or spots on the shins (front of the leg below the knee) of a person with diabetes mellitus
  • Spots found on the front part of the thighs, sides of the feet, scalp, trunk and forearm
  • With time, the patches begin to look like an age spot
  • Spots are a bit scaly and round in shape
  • The spots are bilateral in nature (appear on both the lower legs at the same time)
  • Patches that have been for a long time begin to start indenting slowly
  • The patches are red, tan, dark brown or pink in colour

Diabetic Dermopathy Treatment

This condition is said to improve as time passes. However, it is important that the region of the lesions is kept well-moisturized [10] . It is important that the lower legs do not suffer from any injury as it could worsen the condition with an increase in the number of patches [11] .

Your doctor would be treating you for your general diabetes, so there is no particular medical intervention required for treating the spots, patches or lesions. Nevertheless, it is important that one keeps his or her blood sugar levels under control because that is what triggers dermopathy. Keeping your blood sugar levels under control is the best treatment that you can offer to the dermopathy condition.

When blood glucose levels are under control, not just diabetic dermopathy, plenty of other complications would also be sorted.

Things To Remember While Managing And Treating Diabetic Dermopathy [12]

  • One should religiously monitor his or her blood sugar levels (on a regular basis).
  • The skin should be kept well-moisturized.
  • Prevent injury and other forms of infection (especially on the lower legs).
  • Any unusual skin changes should be reported to the doctor immediately.
  • For people with insulin-dependent diabetes mellitus, it is important to eat their meal at the same time each day.
  • Avoid binge eating
  • The dosage of insulin should be proper and exactly as prescribed by the doctor.
  • In the case of non-insulin dependent diabetes mellitus, the blood sugar levels should be well-balanced with the help of a healthy diet.

It is important to understand that diabetic dermopathy is one of the several complications of diabetes mellitus. Diabetes is a disease that will last forever. Although there is no cure for it, it can very well be managed with simple steps and measures.

View Article References
  1. [1] American Diabetes Association (2010). Diagnosis and classification of diabetes mellitus.Diabetes care,33 Suppl 1(Suppl 1), S62-69.
  2. [2] McCASH, S., & Emanuel, P. O. (2011). Defining diabetic dermopathy.The Journal of dermatology,38(10), 988-992.
  3. [3] Mirhoseini, M., Saleh, N., Momeni, A., Deris, F., & Asadi-Samani, M. (2016). A study on the association of diabetic dermopathy with nephropathy and retinopathy in patients with type 2 diabetes mellitus.Journal of nephropathology,5(4), 139-143.
  4. [4] Brzezinski, P., Chiriac, A. E., Pinteala, T., Foia, L., & Chiriac, A. (2015). Diabetic dermopathy ("shin spots") and diabetic bullae ("bullosis diabeticorum") at the same patient.Pakistan journal of medical sciences,31(5), 1275-1276.
  5. [5] Lipsky, B. A., Baker, P. D., & Ahroni, J. H. (2000). Diabetic bullae: 12 cases of a purportedly rare cutaneous disorder.International journal of dermatology,39(3), 196-200.
  6. [6] Mirhoseini, M., Saleh, N., Momeni, A., Deris, F., & Asadi-Samani, M. (2016). A study on the association of diabetic dermopathy with nephropathy and retinopathy in patients with type 2 diabetes mellitus.Journal of nephropathology,5(4), 139-143.
  7. [7] Duff, M., Demidova, O., Blackburn, S., & Shubrook, J. (2015). Cutaneous manifestations of diabetes mellitus.Clinical diabetes : a publication of the American Diabetes Association,33(1), 40-48.
  8. [8] Casqueiro, J., Casqueiro, J., & Alves, C. (2012). Infections in patients with diabetes mellitus: A review of pathogenesis.Indian journal of endocrinology and metabolism,16 Suppl 1(Suppl1), S27-36.
  9. [9] Shenavandeh, S., Anushiravani, A., & Nazarinia, M. A. (2014). Diabetic muscle infarction and diabetic dermopathy two manifestations of uncontrolled prolong diabetes mellitus presenting with severe leg pain and leg skin lesions.Journal of Diabetes & Metabolic Disorders,13(1), 38.
  10. [10] de Macedo, G. M., Nunes, S., & Barreto, T. (2016). Skin disorders in diabetes mellitus: an epidemiology and physiopathology review.Diabetology & metabolic syndrome,8(1), 63.
  11. [11] Brzezinski, P., Chiriac, A. E., Pinteala, T., Foia, L., & Chiriac, A. (2015). Diabetic dermopathy (“shin spots”) and diabetic bullae (“bullosis diabeticorum”) at the same patient.
  12. [12] Wigington, G., Ngo, B., & Rendell, M. (2004). Skin blood flow in diabetic dermopathy.Archives of dermatology,140(10), 1248-1250.

Read more about: diabetes
Story first published: Thursday, April 11, 2019, 9:00 [IST]
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