10.5826/dpc.1204a185
text/xml
2160-9381
2236
en
Marc Sagristà
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Dermoscopy of diabetic dermopathy
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-10-31
2021-12-08
2022-10-31
2022-12-02
e2022185
Dermatol Pract Concept
Marc Sagristà
2022/10/31
10.5826/dpc.1204a185
e2022185
Sant Jaume de Calella Hospital 
2160-9381
en
e2022185
Naik PP, Farrukh SN. Clinical Significance of Diabetic Dermatopathy. Diabetes Metab Syndr Obes. 2020;13: 4823-4827.
Dermoscopy of diabetic dermopathy
https://dpcj.org/index.php/dpc/article/download/2236/1810
                    Dermoscopy of Diabetic Dermopathy
      Montserrat Navarro-Gilo1, Nuria Alberti-Masalleras2, Mercedes de Gea-Fernández1,
                             Anna Domingo3, Marc Sagristà3


1 EAP, Pineda de mar, Spain
2 EAP, Tordera, Spain
3 Sant Jaume de Calella Hospital, Calella, Spain



Citation: Navarro-Gilo M, Alberti-Masalleras N, de Gea-Fernández M, Domingo A, Sagristà M. Dermoscopy of diabetic dermopathy.
Dermatol Pract Concept. 2022;12(4):e2022185. DOI: https://doi.org/10.5826/dpc.1204a185
Accepted: March 23, 2022; Published: October 2022
Copyright: ©2022 Navarro-Gilo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Marc Sagristà, Department of Dermatology and Venereology, Sant Jaume de Calella Hospital, C/Sant Jaume,
209-217. Calella, Spain. E-mail address: marc_sagrista@yahoo.es




Case presentation                                                          been present for the last 3 years (Figure 1A). The patient was
                                                                           diagnosed with type 2 diabetes 18 years ago, with associated
A 43-year-old man presented with asymptomatic multiple,                    retinopathy and nephropathy.
bilateral, small, brown macules on pretibial areas which had




Figure 1. (A) Clinical picture. (B) Dermoscopic image shows two central areas (inside blue dotted-line) surrounded by an ill-defined brown periph-
eral rim. (C) High magnification dermoscopic image. “Ring-like” globular structures can be identified in the brown peripheral rim (black arrows).
Fine scarcely branching linear vessels (white arrows) are separated by blurred grayish-white streaks (*) which look like dusky Wickham striae.


Image Letter | Dermatol Pract Concept. 2022;12(4):e2022185                                                                                      1
    Dermoscopic evaluation of the lesions revealed a distinc-        Teaching point
tive pattern which was characterized by a one or multiple cen-
tral area/s surrounded by an ill-defined brown peripheral rim        Dermoscopic features of diabetic dermopathy (as described
(Figure 1B). “Ring-like” globular structures could be identi-        above) are different from other diseases that can also pres-
fied in the brown peripheral rim. Finally, central areas dermo-      ent with pretibial pigmented patches, such as early lesions
scopically demonstrated several fine scarcely branching linear       of necrobiosis lipoidica, pigmented purpuric dermatosis or
vessels separated by blurred greyish-white streaks which re-         lichen planus.
sembled dusky Wickham striae (Figure 1C).
    The diagnosis of diabetic dermopathy was confirmed by
histopathological assessment. These dermoscopic features show        References
an excellent correlation with histologic findings [1,2]. Thus, the   1. Morgan AJ, Schwartz RA. Diabetic dermopathy: A subtle sign with
greyish-white color of the central area probably corresponds to         grave implications. J Am Acad Dermatol. 2008;58(3):447-451.
increased collagen density and fibroblastic proliferation, and          DOI: 10.1016/j.jaad.2007.11.013. PMID: 18155320.
the fine branching vessels probably are telangiectasias in the       2. Naik PP, Farrukh SN. Clinical Significance of Diabetic Derma-
                                                                        topathy. Diabetes Metab Syndr Obes. 2020;13: 4823-4827.
papillary dermis underlying an atrophic epidermis. The brown
                                                                        DOI: 10.2147/DMSO.S286887. PMID: 33324080. PMCID:
peripheral rim can be explained by hemosiderin deposition in
                                                                        PMC7733392.
dermis and increased melanin of basal cells.




2                                                                          Image Letter | Dermatol Pract Concept. 2022;12(4):e2022185
