Diabetic Dermopathies as Predictive Markers of Cardiovascular and Renal Complications: A Narrative Review

Abstract

Background: Cutaneous manifestations are frequent in diabetes mellitus and may reflect systemic vascular injury. Among them, diabetic dermopathy, necrobiosis lipoidica, scleredema diabeticorum, bullosis diabeticorum, and eruptive xanthomas are clinically significant. Aim: To synthesize current evidence on the associative and potential predictive role of diabetic dermopathies as non-invasive indicators of cardiovascular and renal complications. Methods: A narrative review of studies published between 2010 and 2023 in PubMed, Scopus, and Web of Science was conducted, focusing on links between specific dermopathies and systemic outcomes. Results: Diabetic dermopathy shows consistent associations with microvascular complications such as retinopathy and nephropathy. Necrobiosis lipoidica and scleredema correlate with macrovascular disease and metabolic syndrome, whereas eruptive xanthomas indicate severe dyslipidemia and heightened cardiovascular risk. Evidence is predominantly cross-sectional, with limited sample sizes and heterogeneous diagnostic criteria. Conclusions: Diabetic dermopathies represent emerging clinical indicators of systemic vascular and metabolic burden. Their potential prognostic value supports the integration of dermatological assessment into comprehensive diabetes care. However, due to methodological limitations, these findings should be interpreted as associative rather than causal, and prospective studies are warranted to confirm their predictive significance.