Dermopathy and Retinopathy in Diabetes: Is There an Association?

Abstract

Background/Aims: Diabetic dermopathy is the most common cutaneous marker of diabetes mellitus presenting as single or multiple well-demarcated brown atrophic macules, predominantly on the shins. Although diabetic dermopathy and diabetic retinopathy are both considered by some authors as manifestations of diabetic microangiopathy, only a few studies are published about their possible association. Our purpose was to investigate the association of diabetic dermopathy and diabetic retinopathy. Methods: We conducted a cross-sectional study in an outpatient diabetes clinic during a 6-month period. One-hundred and eighty-one consecutive patients (8 cases of insulin-dependent diabetes mellitus and 173 cases of non-insulin-dependent diabetes mellitus) were examined for the presence of diabetic dermopathy and diabetic retinopathy. Results: Forty-seven (26%) showed diabetic dermopathy and 68 patients (37.6%) suffered from diabetic retinopathy. The frequency of retinopathy in patients with diabetic dermopathy (44%; 30 cases) was significantly greater than in patients without dermopathy (15%; 17 cases; p < 0.0001). Retinopathy showed a statistically significant association with dermopathy [odds ratio (OR): 3.60; 95% confidence interval (CI): 1.53–8.44; p = 0.003] and diabetes duration (OR: 3.36; 95% CI: 1.67–6.77; p = 0.001). Conclusion: Our study further supports that diabetic dermopathy might be used as a telltale sign of diabetic retinopathy, necessitating more intensive ophthalmologic care, especially in long-lasting diabetes.

Diabetic dermopathy: A subtle sign with grave implications

“…1,3,6 It may affect male patients twice as often as female ones, but this is not consistently seen. 1,6,8,10,11 Although DD has been reported in patients without diabetes 3 and many believe that it is not pathognomonic of diabetes mellitus, we argue that this is an improper assumption. The only study to have identified DD in patients without diabetes has a fatal flaw.…”

“…8 Furthermore, a 2007 study of 173 patients with diabetes in Tehran, Iran, found that 44% of patients with DD also had retinopathy, as opposed to the 15% who had retinopathy without DD (P \ .0001). 11 This revealed a statistically significant association between diabetic retinopathy and dermopathy (odds ratio: 3.60; 95% confidence interval: 1.53-8.44; P = .003). 11 In Israel, it was discovered that 66% of patients with retinopathy had signs of DD.…”

“…11 This revealed a statistically significant association between diabetic retinopathy and dermopathy (odds ratio: 3.60; 95% confidence interval: 1.53-8.44; P = .003). 11 In Israel, it was discovered that 66% of patients with retinopathy had signs of DD. 6 This study also reported the presence of DD in 62% of patients with neuropathy and in 63% of patients with nephropathy.…”

“…2,6,7 The incidence of DD ranges from 9% to 55%. 1,6,[8][9][10][11][12] This distribution may result from variations among the sample sizes and ethnicities of the study groups. For example, the lowest incidence was noted among Indian patients, whose complexion may render DD more difficult to detect.…”

Relação entre retinopatia diabética e dermopatia diabética em pacientes portadores de diabetes mellitus tipo 2

“…Os resultados são variados na literatura. Um estudo encontrou relação estatisticamente significativa entre ambas, com igual distribuição entre sexos e grupos etários, porém apenas para pacientes com mais de 10 anos de evolução da doença (26) . Noutra publicação, os autores não encontraram associação entre essas duas manifestações (24) .…”