Diabetic Dermopathy in Older People - Causes, Symptoms, and Treatment

What Is Diabetic Dermopathy?

Diabetic dermopathy or spotted leg syndrome is a skin condition that occurs in people with diabetes. It is characterized by brownish or reddish lesions, which are typically round or oval in shape. Diabetic dermopathy occurs in the shin, an area in front of the leg and below the knee. Hence, it is also known as shin spots or pigmented pretibial patches. Rarely it occurs on the thighs and arms. Diabetic dermopathy does not occur with any symptoms and is harmless.

People over 50 with prolonged diabetes are at higher risk for diabetic dermopathy. Males are more commonly affected than females. It is seen in almost 50 percent of diabetes patients. Cardiovascular disease is also considered a risk factor for diabetes dermopathy.

Other skin conditions associated with diabetes are:

• Vitiligo: It is an autoimmune condition that causes patches of the skin to lose pigment.

• Scleredema Diabeticorum: It is the thickening and hardening of the skin in neck, shoulders, arms, and upper back and is seen in some people with diabetes.

• Acanthosis Nigrans: It is a skin condition that causes dark patches on the body due to diabetes or any hormonal changes.

What Are the Causes of Diabetic Dermopathy in Older People?

The underlying cause of diabetic dermopathy is not known. When the blood sugar level spikes in diabetes patients, the nerves of the skin and the blood vessels can get damaged. It commonly occurs in uncontrolled diabetes. This damage can lead to poor circulation, which over time results in delayed wound healing. When the person gets involved in leg injuries, shin spots can occur as a response to the trauma. It can also occur due to neuropathy or nerve damage when a person is exposed to a severe hot or cold environment.

Diabetic dermopathy is commonly found to be associated with the following diabetic complications:

• Diabetic Retinopathy: When elevated blood sugar levels affect the retina of the eyes, diabetic retinopathy occurs. It is common in people with both type 1 and 2 diabetes for more than 20 years. Diabetic retinopathy, if not treated, can end up in vision loss and blindness.

• Diabetic Nephropathy: It occurs when the high blood sugar level leads to progressive loss of kidney function. Diabetes can thicken and injure the nephrons in the kidney, which makes the filtration process less efficient. Diabetic nephropathy is also known as diabetic kidney disease. More than 40 percent of kidney failures occur due to diabetes.

• Diabetic Neuropathy: When elevated blood sugar levels affect nerves, diabetic neuropathy occurs. It commonly affects the nerves of the legs and feet. In some people, the symptoms are mild. While in others, diabetic neuropathy can cause painful sensations.

What Are the Symptoms of Diabetic Dermopathy?

Diabetic dermopathy presents with a lesion that has the following features:

• Reddish or brownish macules or patches.

• Round or oval in shape.

• Size can range from several millimeters to two centimeters.

• Scaly or slightly indented into the skin.

• Asymmetrical pattern.

• Appear either in one or both legs.

Besides shin, lesions can rarely appear on the arms, trunk, and thighs. Diabetic dermopathy lesions will not cause any pain, itching, or burning sensations or release fluids. Hence, they are asymptomatic. Diabetic dermopathy typically lasts for a few months to two years. In many cases, when the lesions begin to fade, new lesions start appearing.

How Is Diabetic Dermopathy Diagnosed?

The doctor will perform a physical examination that involves analyzing the site, number, size, and color of lesions. They will also inquire about how long the lesion has been present, and whether it is painful or has any burning sensations. The doctor will also check for balancing, which involves pressing the lesion and seeing whether it becomes paler. This is followed by a blood test to check blood sugar levels. In many people, diabetic dermopathy occurs after they get diagnosed with diabetes for a long time. However, in rare cases, it can occur as an initial sign of diabetes. If the doctor diagnoses the lesion as diabetic dermopathy, a biopsy isn’t required. But if another skin condition is suspected, then it may be required.

Doctors will check for the following symptoms to confirm the diagnosis of diabetic dermopathy:

• Frequent urination.

• Increased thirst or hunger.

• Weight loss.

• Tiredness.

• Tingling sensation in hands and feet.

• Delayed healing of wounds.

What Is the Treatment of Diabetic Dermopathy in Older People?

There is no specific treatment for diabetic dermopathy. However, keeping diabetes under control can prevent diseases and other complications associated with diabetes.

Even though no treatment is required for diabetic dermopathy. Its appearance can be managed in the following ways:

• Applying makeup on the area of lesions.

• Using moisturizer to improve the texture of lesions.

Diabetic dermopathy can be considered a sign of uncontrolled diabetes. It is also found that controlling diabetes does not accelerate the process of fading of lesions. Once it appears, it may take up to a few months or two years. But managing diabetes can prevent the reappearance of lesions.

How to Prevent Diabetic Dermopathy in Older People?

The prevention of diabetic dermopathy focuses on managing diabetes. Following are the measures to manage diabetes:

• Taking Prescribed Medications Regularly: After getting diagnosed with diabetes, medications prescribed by doctors have to be taken regularly without fail.

• Regular Checking of Blood Sugar: It can be done with a glucometer or by continuous glucose monitoring (CGM). Diabetic patients should check blood sugar before and after meals as well as before going to bed.

• Consulting Doctor Regularly: Reach out to the doctor or healthcare professional for the treatment plan and ask for tips to manage diabetes.

• Regular Exercise: Exercising daily has many benefits including improving insulin sensitivity, which helps to manage the levels of blood sugar. 30 minutes of workout for at least four days a week is beneficial.

• Healthy Diet: Diabetes patients have to manage their diet by reducing the refined carbohydrates and sugars in their diet.

Conclusion:

Diabetic dermopathy occurs in patients with prolonged diabetes and commonly occurs in the shin of the leg hence the name shin spot. It's a benign condition that does not require any specific treatment. Although it's harmless, it shouldn't be ignored. The condition indicates the damage of nerves and blood vessels due to prolonged diabetes. It is often a warning sign of uncontrolled diabetes. Managing diabetes is the treatment and prevention strategy for diabetic dermopathy.