Diabetic Dermopathy: Pictures, Symptoms, Treatment

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Diabetic dermopathy is a condition characterized by small, brown skin lesions on the shins of patients with diabetes. Also called shin spots, the lesions are not accompanied by other symptoms and do not cause pain. They are most common in people older than 50 with a long history of diabetes.

Diabetic dermopathy occurs in up to 55% of patients with diabetes and is more likely to occur in people who have other complications related to damaged small blood vessels, such as retinopathy (eye problems), nephropathy (kidney issues), and neuropathy (nerve problems).

shins with diabetic dermopathy and wound on shin

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Pictures of Diabetic Dermopathy

This photo contains content that some people may find graphic or disturbing.

diabetic dermopathy

Dermnet

This photo contains content that some people may find graphic or disturbing.

diabetic dermopathy

Dermnet

This photo contains content that some people may find graphic or disturbing.

diabetic dermopathy

Dermnet

Symptoms 

Lesions of diabetic dermopathy are typically less than 1 centimeter in length and usually begin as flat, scaly areas of thickened collagen that are red or purple. They then progress to scar-like formations that fade to a brown color.

Diabetic dermopathy occurs on both shins in an asymmetrical pattern, but it has also been reported on the thighs, arms, and abdomen in rare cases.

Each diabetic dermopathy lesion lasts about 18–24 months before clearing completely or fading. As old lesions begin to fade and clear up, new lesions often begin to form. Diabetic dermopathy is painless and is usually not associated with other symptoms like itching, burning, or tingling.

Causes

The exact cause of diabetic dermopathy is unknown. However, it may result from damage to the nerves of the skin and damage to the small blood vessels that supply oxygen to the tissues. This decreased circulation can delay wound healing.

Nerve and blood vessel damage occurs from chronically elevated blood sugar that is characteristic of diabetes and results in widespread inflammation throughout the body.

Dermopathy is often seen in those with retinopathy, neuropathy, and kidney issues. It's important to keep diabetes well-managed to avoid other serious complications (beyond dermopathy), such as:

  • Nerve damage
  • Increased risk of stroke or heart attack
  • Kidney damage

Diagnosis

A diagnosis of diabetic dermopathy is made through a physical exam by a physician. Because it is a benign condition, not threatening to life or health, skin biopsies are rarely performed, especially because patients with diabetes commonly have delayed wound healing. Having a skin biopsy also can increase the risk of infection afterward.

Lesions of diabetic dermopathy typically occur in patients with a longstanding history of diabetes, but occasionally they may present as the first sign of diabetes before a diagnosis is made. In some cases, diabetic dermopathy may occur many years before other symptoms of diabetes become evident.

While it has been reported that diabetic dermopathy is more common in type 2 diabetes, it can occur in both type 1 and type 2 diabetes.

Common symptoms of diabetes that may aid in the diagnosis of diabetic dermopathy include:

  • Elevated fasting blood glucose of 126 milligrams per deciliter (mg/dL) or higher
  • Elevated hemoglobin A1C of 6.5% or higher
  • Slow wound healing
  • Frequent urination
  • Increased thirst and hunger
  • Numbness or tingling in the hands and feet

Treatment

Because diabetic dermopathy is an asymptomatic and benign condition, it requires no treatment. However, further assessment and management of diabetes and related complications may be required.

Diabetic dermopathy is often associated with nerve and blood vessel damage that can cause more serious problems, such as peripheral neuropathy, diabetic ketoacidosis, frequent infections, kidney disease, eye problems, and arthropathies (joint diseases).

Good management of diabetes in regulating blood sugar levels may help decrease the likelihood of developing diabetic dermopathy. You can lower your blood sugar levels and prevent worsening of diabetes by: 

  • Monitoring your blood sugar and administering insulin as recommended by your doctor
  • Regularly taking your medication as prescribed by your doctor
  • Managing your diet by reducing the amount of sugar and refined carbohydrates you eat while consuming more foods that can help lower blood sugar 
  • Exercising for a minimum of 30 minutes at least three times a week to increase uptake of sugar from the blood into the muscles
  • Losing weight to decrease the severity of diabetes 

Coping

Patches may fade over time, but it is common for new lesions to appear as the old ones are clearing up. Keeping your skin moisturized with lotion or natural oils can help improve the elasticity and appearance of your skin and the decreased dryness of patches.

Summary

Diabetic dermopathy is a complication of diabetes that causes brown lesions to appear on your skin. It's a benign condition that does not require treatment. However, as lesions clear up, new ones may form. Keeping your diabetes under control can reduce your chances of developing this condition.

A Word From Verywell

Diabetic dermopathy is a common occurrence that affects many patients with diabetes. While there is no way to cure diabetic dermopathy, having good control over blood sugar levels can prevent the lesions of diabetic dermopathy from occurring and decrease the likelihood of other diabetes-related complications.

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  1. George SMC, Walton S. Diabetic dermopathy. Br J Diabetes Vasc Dis. 2014;14:95-97. doi:10.15277/bjdvd.2014.027

  2. Timshina DK, Thappa DM, Agrawal A. A clinical study of dermatoses in diabetes to establish its markers. Indian J Dermatol. 2012 Jan;57(1):20-5. doi:10.4103/0019-5154.92671