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diabetic dermopathy

Can you identify this asympomatic rash on a 53-year-old man's leg?

DAVID L. KAPLAN, MD—Series Editor
University of Missouri Kansas City, University of Kansas_

Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine.  He practices adult and pediatric dermatology in Overland Park, Kansas.   

Volume 52 - Issue 3 - March 2012

 diabetic dermopathy

A 52-year-old man with diabetes mellitus presents for evaluation of an asymptomatic rash on his right leg. The lesions have been present for 2 months.

Which of the following do you supect?

A.Stasis dermatitis.

B.Lichen planus.

C.Dermatophyte infection.

D.Diabetic dermopathy.

E.Necrobiosis lipoidica diabeticorum.

(Answer on next page.)

diabetic dermopathyAnswer: Diabetic dermopathy

Diabetic dermopathy, D, is thought to be a microangiopathic condition that produces asymptomatic, hyperpigmented macules on the shins of persons with diabetes.

Stasis dermatitis is not as discrete and erupts on the lower legs. Lichen planus features purplish plaques. Erythema and scale are characteristic of the less pigmented lesions of dermatophyte infections. Necrobiosis lipoidica diabeticorum plaques are usually atrophic and orangish.