From the Guidelines
Diabetic dermopathy is caused by microvascular changes associated with diabetes mellitus, specifically damage to small blood vessels in the skin leading to reduced blood flow and localized tissue damage. The condition is characterized by small, round, brownish lesions, often referred to as "shin spots", which develop due to inflammation and the deposition of hemosiderin from damaged blood vessels.
Key Factors Contributing to Diabetic Dermopathy
- Damage to small blood vessels in the skin
- Reduced blood flow to the skin
- Localized tissue damage
- Inflammation
- Deposition of hemosiderin
Prevention and Management
- Good diabetes management, including maintaining target blood glucose levels
- Regular exercise
- Appropriate medication adherence
- No specific treatment is needed for the lesions themselves, as they are harmless The provided evidence 1 focuses on diabetic foot infections and their management, but does not directly address the causes of diabetic dermopathy. However, the underlying theme of microvascular changes and their impact on tissue health is relevant to understanding diabetic dermopathy. The most recent and highest quality study is not directly applicable to diabetic dermopathy, but the principles of good diabetes management and the importance of microvascular health are consistent across these studies.
Important Considerations
- Diabetic dermopathy is more common in patients with long-standing diabetes
- Poor glycemic control and other diabetes complications, such as neuropathy, nephropathy, or retinopathy, increase the risk of diabetic dermopathy
- Good diabetes management is key to preventing or minimizing diabetic dermopathy
- The lesions themselves are harmless, but may take months or years to fade.
From the Research
Causes of Diabetic Dermopathy
The exact mechanism of diabetic dermopathy is unknown, but several studies suggest possible causes:
- Impaired wound healing due to decreased blood flow 2
- Local thermal trauma 2
- Local subcutaneous nerve degeneration 2
- Abnormal local skin blood flow 3, 4
- Microangiopathic complications of diabetes, such as nephropathy, retinopathy, and polyneuropathy 2
Associated Factors
Diabetic dermopathy has been associated with:
- Chronic micro- and macro-vascular dysfunction 5
- Reduced skin blood flow reserve 3, 4
- Decreased skin perfusion due to diabetes 3
- Older age and longer duration of diabetes 4
Pathophysiology
The pathophysiology of diabetic dermopathy is not fully understood, but it is thought to involve: