Shin Spots and Diabetes Mellitus

Diabetic dermopathy: A subtle sign with grave implications

“…DD has been known by many names, each characterizing its clinical presentation. It has been referred to as ''atrophic lesions'' by Melin, 1 ''shin spots'' by Danowski et al, 3 ''pigmented pretibial patches'' by Bauer et al, 4 and ''spotted leg syndrome'' by Murphy. 5 ''Diabetic dermopathy'' is currently the most widely used term.…”

“…10 DD is seen more frequently in older patients, especially those older than 50 years, and those who have had diabetes mellitus for a longer period of time. 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.…”

Skin Blood Flow in Diabetic Dermopathy

“…[1][2][3][4][5][6][7] Diabetic dermopathy appears as round to oval atrophic hyperpigmented macules on the pretibial areas of the lower extremities. The lesions are usually bilateral and have an asymmetric distribution.…”

Sex Distribution and Frequency of Diabetic Concomitants or Complications

“…The following information was obtained by the same group of observers during one or more sessions: age, sex, age at diagnosis, duration of diabetes since diagnosis, therapy, blood pressure while sitting and standing, body weight and height, status of fundi, pedal pulses, ankle reflexes, vibration perception at the malleoli, and the presence or absence of paresthesia, pain in the extremities, and hyperpigmented and retracted scars of the antero-lateral lower legs (shin spots). 17 The following criteria were employed: Hypertension: systolic readings of 160 or higher with a diastolic blood pressure of 100 mm. Hg or higher; Obesity: body weight in excess of 200 pounds in males and 170 pounds in females; Retinopathy: presence of microaneurysms, hemorrhages, exudates, neovascularization, retinitis proliferans, retinal detachment, and blindness, alone or in combination; Absence of pedal pulses: both dorsalis pedis and both posterior tibial pulsations absent; Absence of ankle reflexes: areflexia during facilitation while kneeling; Increased threshold for vibratory sense: diminished perception of the movements of a Biothesiometer 18 as reflected by readings of 30 or higher at the external and internal malleoli of both ankles; Orthostatic hypotension: consistent decrease (greater than 10 mm.…”