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. 2017 Dec 6;9(1):e1395537.
doi: 10.1080/19381980.2017.1395537. eCollection 2017.

Cutaneous manifestations of diabetic peripheral neuropathy

S N Dogiparthi  1 , K Muralidhar  1 , K G Seshadri  1 , S Rangarajan  1
Affiliations

Cutaneous manifestations of diabetic peripheral neuropathy

S N Dogiparthi et al. Dermatoendocrinol. .

Abstract

There is a rise in number of people diagnosed with Diabetes Mellitus. The incidence is rising in modern Indian society because of Industrial development and drastically changing lifestyles. Diabetic neuropathies are microvascular disorders that are usually associated with the duration of Diabetes. Among the various forms, the most common is Diabetic Peripheral Neuropathy. The disease if neglected leads to chronic ulcer formation leading to amputations frequently. Hence the aim of this study is to document the early cutaneous changes and create an early awareness in the importance of controlling Diabetes. The study consisted of 205 patients with Type 2 DM. Participant's neuropathy status was determined based on Neuropathy Disability Score and Diabetic Neuropathy Symptom Score. Among the Skin changes documented, the common changes seen were: Peripheral hair loss in 185 (90.2%), Xerosis in 168 (82%), Anhydrosis in 162 (79%), Plantar Fissures in 136 (66.3%), Plantar Ulcer in 80 (39%), common nail changes documented were Onychomycosis in 165 (80.5%) and Onychauxis in 53 (25.8%) patients in relation to the occupation and duration of Diabetes mellitus. In conclusion, it is important to control glycemic levels in the all stages of Diabetes and institute foot care measures to prevent the complications of neuropathy.

Keywords: Cutaneous Manifestations; Diabetes; Diabetic Neuropathy Symptom Score; Diabetic Peripheral Neuropathy; Neuropathy Disability Score.

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Figures

Figure 1.
Figure 1.
Occupation and barefoot analysis of study participants.
Figure 2.
Figure 2.
DNSS & NDS catergorization of patients.
Figure 3.
Figure 3.
A: Plantar fissures B: Diabetic Blister C: Ulcer D: Ulcer with Squamous Cell Carcinoma E: Charcot Foot F: Hallux Valgus G: Claw toes.
Figure 4.
Figure 4.
Ulcer grade analysis and categorization – majority of patients (36 patients) had superficial ulcers.
Figure 5.
Figure 5.
A: In correlation of NDS with duration of DM, the statistical analysis was significant (P = 0.039). B: DNSS with Ulcer the P value = 0.000 which was highly significant. C: NDS with Ulcer the P value = 0.000 which was highly significant.
Figure 6.
Figure 6.
Shows the highest correlation between Plantar Fissures & Bare feet.
Figure 7.
Figure 7.
Pathogenesis of peripheral neuropathy.
See this image and copyright information in PMC

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