Diabetic Dermopathy

What is Diabetic Dermopathy?

It is a skin condition characterized by shiny round lesion typically red to light brown in color commonly found on the lower legs of people with diabetes mellitus. Its other names are shin spots and pigmented pretibial patches.

The condition is linked to the change in the small blood vessels that supply the skin. The patches or spots are not painful but sometimes cause itching or burning sensation. It can occur any time but usually occur when there is some kind of trauma or injury. ^{(1, 2, 3)}

Image 1: A classic manifestation of diabetic dermopathy.
Picture Source: cdn.diabetesdaily.com

Picture 2: Brown patches on the patient’s legs, the typical manifestation of diabetic dermopathy.
Photo Source: www.diabetesselfcaring.com

Is it a rare condition?

Diabetic dermopathy is not a rare condition. In fact, up to a third of people with diabetes has diabetic dermopathy. Many call it shin spots because of its location. ^{(2, 3)}

Causes

The exact cause of diabetes dermopathy is unknown but medical experts believed that it is linked to damage to the nerves and blood vessels commonly found in diabetic patients.

Diabetic dermopathy may also have a direct link with other conditions that may arise because of diabetes such as diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. ^{(3, 4, 5)}

Diabetic dermopathy is prominent in the following patients:

• Older diabetic patients.
• People who have diabetes for a minimum of 10 years/long-standing diabetes.
• Diabetic patients with high hemoglobin A1c level.
• Uncontrolled diabetes/poorly controlled diabetes.
• Those who have had trauma or injury to the bony aspects of the shins.

It affects both people with insulin dependent diabetes mellitus and non-insulin dependent diabetes mellitus. ^{(4, 5, 6)}

Signs and Symptoms

• Spots or lesions on the shins of a person with diabetes mellitus.
• The lesions or spots can also be found on the front part of the thighs, scalp, sides of the feet, trunk, and forearm.
• The patches/spots are typically pink, red, tan, to dark brown in color.
• The spots are a bit scaly and round in shape.
• Patches that have been around for a long period of time become faintly indented (atrophy).
• The spots are bilateral (found on both shins at the same time).
• Over time, the patch looks like an age spot. ^{(4, 5, 6, 7)}

Photo 3: Brownish to reddish patches on the skin secondary to uncontrolled blood sugar level.
Image Source: cdn.diabetesdaily.com

Why are people with diabetes prone to dermopathy and other forms of skin problems?

A high blood sugar level causes the body to lose fluids and skin to get dry. A dry skin becomes rough and prone to cracking. If left unmanaged could cause itchy skin, which makes you susceptible to various types of infection. ^{(6, 7)}

Diabetic dermopathy Treatment

Diabetic dermopathy usually improves as time passes by. Just make sure that you keep your skin healthy and moisturized. As much as possible, you have to avoid any forms of injury to the legs so as to prevent the lesions or spots from further developing.

There is really no need for medical intervention when it comes to lesions, spots, or patches secondary to diabetes. However, it is important to control your blood sugar level because it is the number one triggering factor for dermopathy. Treatment for diabetic dermopathy is all about taking good care of your blood sugar level.

If you have a problem controlling your blood sugar level, then you need to consult your doctor. Your health care provider will do all the necessary measures to significantly improve your condition. Once your blood sugar level is controlled, it is not only the diabetic dermopathy that will be prevented but as well other complications of diabetes.

Home remedies for diabetic dermopathy are all about eating a healthy diet, healthy and safe exercise routines, and doing all the things your doctor asked you to do. If your doctor prescribes a drug, then you need to do your best to take the drug.

Another important thing to keep in mind is to keep your skin healthy, especially in the areas where spots or patches most likely to occur. Keep the skin moisturized and do your best to prevent any forms of injury.

If the patches or spots get out of control despite your religious measures to control your blood sugar level, then you need to see your doctor. ^{(7, 8, 9, 10)}

Key takeaways to managing and preventing diabetic dermopathy

1. Monitor your blood sugar level religiously.
2. Prevent any forms of injury or infection.
3. Keep your skin moisturized.
4. If you feel any usual changes on your skin, you need to inform your doctor. Do not delay consulting your doctor as doing so can further complicate your condition.
5. If you have an insulin dependent diabetes mellitus, you need to see to it that you eat your meal the same time each day. You also need to make sure that the doses of insulin are proportion to what you eat. Avoid binge eating.
6. If you have a non-insulin dependent diabetes mellitus, manage your blood sugar level by following a healthy diet. If the doctor prescribes medication, you have to stick with it as it can help improve the integrity of your skin.

A diabetic dermopathy is just one of the many complications of diabetes mellitus. Diabetes is a lifestyle disease, which is a life-long one. You cannot do something to cure it, but there are plenty of ways to manage it.

To prevent complications, you need to manage your blood sugar level. Keep it under control because a poorly controlled blood sugar level is the culprit of dermopathy and other types of complications.

Maintain a healthy diet, exercise regularly, and take the medications prescribed by your doctor. Lastly, if you notice any unusual changes in your body, you need to immediately inform your doctor. ^{(1, 4, 7, 10)}

References:

1. https://en.wikipedia.org/wiki/Diabetic_dermopathy
2. https://www.dermnetnz.org/topics/skin-problems-associated-with-diabetes-mellitus/
3. https://www.skinsight.com/skin-conditions/adult/diabetic-dermopathy
4. https://www.diabetesdaily.com/blog/2015/02/what-is-diabetic-dermopathy/
5. https://www.sciencedirect.com/topics/medicine-and-dentistry/diabetic-dermopathy
6. http://www.diabetes.org/living-with-diabetes/complications/skin-complications.html
7. https://www.webmd.com/diabetes/qa/what-is-diabetic-dermopathy
8. https://www.aad.org/public/diseases/other-conditions/diabetes-warning-signs
9. http://www.thesymptomsofdiabetes.org/diabetic-dermopathy/
10. https://www.dermatologyadvisor.com/dermatology/diabetic-dermopathy-pigmented-pretibial-patches-of-diabetes-mellitus/article/691774/