Evaluation of Morphological and Structural Skin Alterations on Diabetic Subjects by Biophysical and Imaging Techniques

Abstract

Diabetes causes increased production of advanced glycation end products (AGEs), which may lead to irreversible damage to collagen fibers, and early and more accentuated signs of skin aging. Thus, the objective of this study was to evaluate diabetic skin’s mechanical and morphological characteristics and compare these to healthy skin. Twenty-eight female participants aged between 39 and 55 years were enrolled: half had type 2 diabetes, and the others were healthy. Wrinkles, transepidermal water loss (TEWL), stratum corneum water content, skin color, elasticity, morphological and structural characteristics of epidermis and dermis echogenicity were evaluated using biophysical and skin imaging techniques. Higher TEWL values were observed in participants with diabetes, who also showed lower skin elasticity and wrinkles with greater volume, area, and depth. In addition, the Reflectance Confocal Microscopy (RCM) imaging analysis showed that all participants with diabetes presented polycyclic papillae and deformed and amorphous collagen fibers. The obtained data showed significant differences between healthy and diabetic skin and could help develop more specific topical treatments to improve the treatment of skin conditions in people with diabetes. Finally, RCM is an advanced imaging technique that allows for a more profound analysis of diabetic skin, which could assist in the evaluation of dermocosmetic treatments to improve the skin alterations caused by this disease.

Enzymatic Deglycation of Damaged Skin by Means of Combined Treatment of Fructosamine-3-Kinase and Fructosyl-Amino Acid Oxidase

“…This is related to collagen-based AGE crosslinking, where these important fibers undergo structural and functional changes and eventually become bridled and dysfunctional [13,36]. This was linked to both a loss of elasticity and a greater presence of wrinkles [22]. In this study, elongation testing of the excised HTS specimen demonstrated that with skin deglycation and the reversal of AGE-induced crosslinking by use of FN3K, decreased scar rigidity can be obtained.…”

“…A recent publication by Moraes et al (2023) compared the skin parameters between a diabetic and healthy population using bio-functional measurements and reflectance confocal microscopy [22]. The authors showed that the skin quality was altered.…”

“…Owing to the accumulation of AGEs, human aging leads to skin stiffening. This is due to damage to collagen fibers caused by Maillard reactions [22]. Moreover, it has been elaborately described that AGEs play an important pathological role in the dermal wound healing process and the current evidence on the role of AGEs in scar formation indicates that a higher accumulation of these products tends to produce more rigid, contractile scars with a persistent erythematous appearance [12,23].…”

Short-Term l-arginine Treatment Mitigates Early Damage of Dermal Collagen Induced by Diabetes

“…In the spectral range 1000-1150 cm −1 , several bands in the spectra of the diabetic skin increase in intensity compared to the control sample, such as 1035 cm −1 , 1067 cm −1 , and 1100 cm −1 , which are associated with phenylalanine and proline [36,37,49]. According to Carcamo et al [49], proline has a broader band at 1100 cm −1 , attributed to N-C-H deformation, with increased intensity in the diabetic skin, suggesting the structural degradation of the collagen molecule [5,50,51], which we consider a pathological mechanism. L-arginine treatment does not reverse the intensities of these modes.…”