Spectrum of cutaneous manifestations in diabetes mellitus and their association with duration of diabetes mellitus: An observational study in a tertiary care hospital of South India.

Swapna Kameti, Senthil Kumar A L, Vijaya Mohan Rao A, Penchala Reddy P, C Aruna


Background: Diabetes mellitus (DM) is a worldwide problem and the most common endocrine disorder. Cutaneous manifestations of DM generally appear subsequent to the development of the disease, but they may be the first presenting sign or even precede the primary disease manifestation by many years. Aim: To study the prevalence and patterns of cutaneous manifestations among diabetic patients and their association with duration of DM. Materials and Methods: A longitudinal cross-sectional study was performed on patients attending the out patient department of Dermatology, Venereology and Leprosy of a tertiary care hospital in South India. A total of 200 patients with dermatological compliants having pre-existing diabetes and patients in whom diabetes was diagnosed later were included in the study. Statistical analysis was carried out using analysis of variance (ANOVA) test and SPSS 21 software. Results: Majority of  patients belonged to the age group 40-59 years (63%) with female preponderance (58.5%). Cutaneous manifestations as presenting feature of diabetes were observed in 21.5% cases. The diabetic status was uncontrolled in 73% cases. Among the various cutaneous manifestations observed, cutaneous infections (52%) were most commonly observed, especially in early diabetics of upto 5 years duration and dermatoses due to chronic degenerative complications were observed in long standing diabetics which was statistically significant (P<0.05). Conclusion: Cutaneous manifestations may be the first clue to underlying diabetic diathesis. Through awareness about cutaneous manifestations of DM, dermatologist can not only take credit for detecting DM but also facilitate early diagnosis of systemic complications of DM and thereby play an important role in improvement of quality of life and management strategy of diabetic patients.


Cutaneous manifestations; diabetes mellitus; infections; South India

Full Text:



Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. The Lancet 2016;387:1513-1530.

Bhat YJ, Gupta V, Kudyar RP. Cutaneous manifestations of diabetes mellitus. Int J Diab Dev Ctries 2006;26:152–5.

Kalus AA, Chein AJ, Olerud JE. Diabetes mellitus and other endocrinal disorders. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Lefell DJ, editors. Fitzpatrick’s Dermatology in General Medicine. 7th ed. Newyork: McGraw Hill Medical: 2008. p. 1461-84.

Al-Mutairi N. Skin diseases seen in diabetes mellitus. Bulletin of Kuwait Institute of Medical Specialization 2006;5:30-39.

Bud JL, Oledur JE. Diabetes Mellitus. Fitzpatrick’s Dermatology in General Medicine. 6th ed. Vol. 2.Newyork, Toronto; McGraw Hill Companies; p. 1651-61.

Jelinek JE. Cutaneous manifestations of diabetes mellitus. Int J Dermatol 1994;33: 605-17.

Peterka ES, Fusaro RM. Cutaneous Carbohydrate Studies IV. The skin glucose content of fasting diabetics with and without infection. J Invest Dermatol 1966;46:459-463.

Mahajan S, Koranne R V, Sharma S K. Cutaneous manifestation of diabetes melitus. Indian J Dermatol Venereol Leprol 2003;69:105-8.

Nigam P K, Pande S. Pattern of dermatoses in diabetics. Indian J Dermatol Venereol Leprol 2003;69:83-5.

Sawhney M, Talwar O P, Tutakne M A, Rajpathak S D. Diabetic dermoangiopathy:A clinico-pathological correlation. Indian J Dermatol Venereol Leprol 1992;58:173-8.

Rao S, Pai G. Cutaneous manifestations of diabetes mellitus. Indian J Dermatol Venereol Leprol 1997;63(4):232–34.

Al-Mutairi N, Zaki A, Sharma AK, Al-Sheltani M. Cutaneous manifestations of diabetes mellitus. Med Princ Pract 2006;15:427–30.

Vahora R, Thakkar S, Marfatia Y. Skin, a mirror reflecting diabetes mellitus: A longitudinal study in a tertiary care hospital in Gujarat. Indian J Endocr Metab 2013;17:659-64.

Yosipovitch G, Hodak E, Vardi P, Shraga I, Karp M, Sprecher E, et al. The prevalence of cutaneous manifestations in IDDM patients and their association with diabetes risk factors and microvascular complications. Diabetes Care 1998;21:506-9.

Feringer T, Miller FO. Cutaneous manifestation of diabetes mellitus. Dermatol Clin 2002;20:483-92.

Hahler B. An overview of dermatological conditions commonly associated with the obese patient. Ostomy Wound Manage 2006;52:34-36.

Sibbald RG, Schachter RK. The skin and diabetes mellitus. Int J Dermatol 1984;23:567-84.

Binkley GW. Dermopathy in the diabetic syndrome. Arch Dermatol 1965;92:625-634.

Crook MA. Skin tags and atherogenic lipid profile. J Clin Pathol 2000;53:873-4.

Kahana M, Grossman E, Feinstein A, Ronnen M, Cohen M, Millet MS. Skin tags: A cutaneous marker for diabetes mellitus. Acta Dermatol Venereol 1987;67:175-7.

Thappa DM. Skin tags as markers of diabetes mellitus: An epidemiological study in India. J Dermatol 1995;22:729-31.

Kahn CR, Flier JS, Bar RS, Archer JA, Gorden P, Martin MM, et al. The syndromes of insulin resistance and acanthosis nigricans: Insulin-receptor disorders in man. N Engl J Med 1976;294:739-45.

Ragunatha S, Anitha B, Inamadar AC, Palit A, Devarmani SS. Cutaneous disorders in 500 diabetic patients attending diabetic clinic. Indian J Dermatol 2011;56:160-4.


  • There are currently no refbacks.

ISSN: 1560-9014