Relationship between skin diseases and extracutaneous complications of diabetes mellitus: clinical analysis of 750 patients

Am J Clin Dermatol. 2014 Feb;15(1):65-70. doi: 10.1007/s40257-013-0048-2.


Background: The relationship between skin diseases and extracutaneous complications in diabetes mellitus (DM) is unclear.

Objective: We aimed to investigate the relationship between skin disorders and diabetic neuropathy, nephropathy, and retinopathy in patients with DM.

Methods: A total of 750 patients with DM were prospectively enrolled. Demographic and clinical features, skin disorders, glycosylated hemoglobin (HbA1c) levels, and presence of nephropathy, neuropathy, and retinopathy were noted.

Results: Of the patients, 38.0% had neuropathy, 23.3% had nephropathy, and 22.9% had retinopathy. Any skin disorder was present in 79.2% (n = 594) of patients. The most common skin manifestations were cutaneous infections (47.5%), xerosis (26.4%), and inflammatory skin diseases (20.7%). The frequency of cutaneous infections, fungal infections, diabetic foot, rubeosis faciei, and pigmented purpuric dermatitis was higher in patients with nephropathy than in those without nephropathy. Cutaneous infections, diabetic foot, rubeosis faciei, and diabetic dermopathy were more common in patients with neuropathy. Fungal infections, diabetic foot, rubeosis faciei, diabetic dermopathy, and pigmented purpuric dermatitis were more frequent in patients with retinopathy. Patients with HbA1c ≥8 mmol/mL had more skin disorders than those with HbA1c <8 mmol/mL (P < 0.05 for all).

Conclusion: Skin disorders may be clues to the presence of associated microvascular complications of DM.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / epidemiology
  • Diabetic Neuropathies / complications
  • Diabetic Neuropathies / epidemiology
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / epidemiology
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Skin Diseases / epidemiology
  • Skin Diseases / etiology*
  • Skin Diseases / pathology
  • Young Adult


  • Glycated Hemoglobin A