Is diabetic dermopathy a sign for severe neuropathy in patients with diabetes mellitus? Nerve conduction studies and symptom analysis

Abstract

Objective To assess if diabetic dermopathy (DD) is a sign for severe polyneuropathy (PNP). Methods We investigated the clinical and electrophysiological characteristics of 166 diabetic men (59.5+11.1 years) with different degrees of peripheral nerve involvement. Results All of the clinical variables were more common in patients with diabetic foot ulcers (DF) than in patients with sole PNP ( P<0.001). Only the loss of superficial and vibration sense was more common in the DF patients than the DD patients ( P<0.02). Nerve conduction studies showed the mean compound muscle action potentials (CMAP) were smaller in the DD and DF patients than the PNP patients for peroneal, median and ulnar nerves ( P<0.01). The mean nerve conduction velocities (NCV) of all nerves were slower in the DD and DF patients in compared to sole PNP patients ( P<0.01). The mean distal latencies (DL) of the DD/DF patients were longer than the PNP group. Conclusions The DD and DF patients did not significantly differ in CMAP, NCV, and DL. Significance: Both clinical and electrophysiological features of DD and DF are similar, and significant different than PNP alone. These results suggest that DD is an important clinical sign for more severe neuropathic impairment.