Skin, scalp, oral mucosa and nail findings in patients with Type 2 diabetes mellitus and evaluation of the relationship of these findings with diabetic complications

Diabetes mellitus (DM) and the microvascular and macrovascular complications it causes are important for patients in terms of morbidity and mortality. The skin and skin appendages reveal the systemic effects of DM. Dermatological findings contribute to the early diagnosis of DM and to the assessment of metabolic control level and complications. In this study, we aimed to examine the findings of the skin, scalp, oral mucosa, and nails in patients with type 2 DM and to evaluate their associations with diabetic complications and some metabolic, demographic parameters. Patients with type 2 DM who attended to our clinic between September 2024 and March 2025 were included in the study. A total of 584 participants were enrolled, including 390 patients with type 2 DM and 194 individuals in control group. Individuals in the control group were selected from volunteers without chronic diseases and laboratory abnormalities. Patients' age, sex, body mass index, duration of diabetes, and diabetic complications were recorded. Dermatological examinations were performed and the findings were documented. Statistical analysis was conducted using SPSS version 22.0. In the DM group, the most common dermatological finding was xerosis cutis, which was significantly more frequent compared to the control group (44.9%; p<0.001). Acrochordons were the second most common finding, followed by cutaneous infections (44.6% and 41%, respectively). Cherry angioma (30.8%) was also significantly more prevalent in the DM group than in controls (p<0.001). Among hair findings, androgenetic alopecia was the most frequent (27%; p<0.001). Onychomycosis was the most common cutaneous infection (23.8%; p<0.001). Regarding oral mucosal findings, only decayed tooth showed a significant association (p<0.001). Among nail findings, subungual hyperkeratosis (33.3%) and yellow nails (29.7%) were the most prominent. Significant associations were observed between diabetic neuropathy and onychomycosis (p=0.004), as well as between diabetic nephropathy and diabetic foot, tinea, and diabetic bullae (p<0.001, p=0.016, p=0.036, respectively). Other dermatological findings were also found to be associated with diabetic complications." Dermatological findings are commonly observed in individuals with DM and show significant associations with some diabetic complications. As dermatological manifestations may reflect the systemic effects of DM, skin examination should be considered an integral part of a comprehensive approach during patients' follow-up.