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CLUE TO DIABETES

JAMA. 1966;195(6):483. doi:10.1001/jama.1966.03100060123036.
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Diabetes Week has come, and gone: those screened may comfortably forget the disease until next November. Not so the clinician. In 1964 and 1965 several publications described skin lesions, cutaneous manifestations of microangiopathy, which may prove to be clues to the presence of diabetes.1,2 The skin lesions are discrete, most often multiple, round or oval, flat, large, dull red papules. If acute, a vesicle may be seen, followed by erosion of the epidermis. During the slow evolution and healing, both the erosions and papules are covered with a thin keratin crust or scale. Months later the atrophic stage is observed resulting in a permanent stigma, a pale or light brown scar slightly depressed below the surrounding skin. These lesions generally are distributed in a linear pattern on the extensor surfaces of both upper and lower extremities, although rarely on the forearms.

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