Evaluation of Morphological and Structural Skin Alterations on Diabetic Subjects by Biophysical and Imaging Techniques

Diabetes causes increased production of advanced glycation end products (AGEs), which may lead to irreversible damage to collagen fibers, and early and more accentuated signs of skin aging. Thus, the objective of this study was to evaluate diabetic skin’s mechanical and morphological characteristics and compare these to healthy skin. Twenty-eight female participants aged between 39 and 55 years were enrolled: half had type 2 diabetes, and the others were healthy. Wrinkles, transepidermal water loss (TEWL), stratum corneum water content, skin color, elasticity, morphological and structural characteristics of epidermis and dermis echogenicity were evaluated using biophysical and skin imaging techniques. Higher TEWL values were observed in participants with diabetes, who also showed lower skin elasticity and wrinkles with greater volume, area, and depth. In addition, the Reflectance Confocal Microscopy (RCM) imaging analysis showed that all participants with diabetes presented polycyclic papillae and deformed and amorphous collagen fibers. The obtained data showed significant differences between healthy and diabetic skin and could help develop more specific topical treatments to improve the treatment of skin conditions in people with diabetes. Finally, RCM is an advanced imaging technique that allows for a more profound analysis of diabetic skin, which could assist in the evaluation of dermocosmetic treatments to improve the skin alterations caused by this disease.