RESUMO
There are many cutaneous signs in diabetes mellitus [DM] which is the most common endocrine disorder among the general population. Diabetic Dermopathy [DD] or Shin Spots are the most common cutaneous signs of diabetes. Although they occur individually in people who do not have diabetes, if four or more are present the specificity is high for microvascular disease in other tissues. This study was done to evaluate frequency of diabetic dermopathy among diabetic patients and use this obvious subtle clinical sign as marker for early detection of atherosclerotic changes in diabetic patients including myocardial infarction. This study was done at diabetic center in Sulaimani intensive care unit[IUC] in teaching hospital of Suliamani during the period from November 2008 to June 2009. A total of 384 patients with Diabetes mellitus were included in this descriptive case series hospital-based study. All patients were diagnosed by specialist diabetician as a case of DM depending on classic diagnostic criteria of DM. All patients were thoroughly assessed regarding the age, sex, skin color, duration of diabetes mellitus and treatment regime. Careful skin examinations has been performed for diabetic dermopathy, diabetic wet gangrene of foot. Diagnosis of myocardial infarction was done either by electrocardiographic changes or by plasma biochemical marker. Eighty four [21.9%] case with DD were reported in our study; fifty four [64.3%] case of them were females while the remaining 30 [35.7%] cases were male. Diabetic patients with myocardial infarction were 44[11.5%] cases, 36 cases as acute MI. while the other eight cases were old cases of MI. Of these 44 cases 16[36.4%] had DD while 28[63.6%] had no DD. There was a statistically significant association between the myocardial infarction and the frequency of diabetic dermopathy and we should use this obvious subtle clinical sign as marker for early detection of atherosclerotic changes in diabetic patients including myocardial infarction. Wet gangrene of the foot is also considered a marker of bad glycemic control.