Eccrine Coil Elastosis: A New Dermatopathological Feature Associated With Prediabetes and Diabetes

Area of Science:

• Dermatology
• Endocrinology
• Histopathology

Background:

• Diabetes mellitus prevalence is increasing globally.
• Known cutaneous manifestations include microangiopathy and atherosclerosis.
• Eccrine coil elastosis, a change in sweat gland elastin, was previously unreported in diabetes.

Purpose of the Study:

• To investigate the association between eccrine coil elastosis and metabolic/cardiovascular risk factors.
• To determine if eccrine coil elastosis is a potential histological marker for diabetes or prediabetes.

Main Methods:

• Retrospective analysis of 245 skin biopsies.
• Assessment of eccrine coil elastosis types (stretching, thickening, waving, multilamellation, fragmentation) and extent.
• Lysozyme immunostaining for confirmation in ambiguous cases.

Main Results:

• Eccrine coil elastosis (waving, multilamellation, thickening) was independently associated with diabetes or prediabetes.
• Associations were also observed with cardiovascular complications, age, and actinic damage.
• No significant associations were found with hypertension, dyslipidemia, smoking, or overweight.

Conclusions:

• Eccrine coil elastosis is significantly more prevalent and appears earlier in patients with prediabetes and diabetes.
• This finding can serve as a histological clue for further metabolic evaluation in patients with unknown glycemic status.