II. Epidemiology

  1. Most common skin finding in Diabetes Mellitus
    1. More common if comorbid Diabetic Neuropathy
  2. More common in men

III. Pathophysiology

  1. Skin Hyperpigmentation due to hemosiderin deposition
  2. May be associated with Trauma

IV. Symptoms

  1. None

V. Signs

  1. Round hyperpigmented areas
    1. Initial: flat-topped, red and scaly Papules
    2. Later: Depressed below skin level
  2. Distribution
    1. Bilateral shins (most common)
    2. Forearms
    3. Anterior thighs
    4. Lateral feet

VI. Course

  1. Heal spontaneously
  2. May leave preciously involved skin with altered pigment

VII. References

  1. Habif (1996) Dermatology, p. 624
  2. Marx (2002) Rosen's Emergency Medicine, 1759-60

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