Diabetes increases the advanced glycation end products – AGEs in the tissue, causing damages. In the skin, this glycation can induce AGE in the dermis, which can cause changes in the collagen. Thus, diabetic patients are more predisposed to signs of early aging than healthy people.  Reflectante Confocal Microscopy (RCM) is a non-invasive imaging technique that allows the epidermis and papillary dermis analyses in real-time. In this context, the aim of this study was to evaluate the clinical changes in the diabetic type 2 skin by biophysical skin imaging techniques  For this, 28 participants, 14 diabetic type 2 and 14 nondiabetic (control group), were recruited for the clinical study of skin characterization. The analyses were performed in the nasolabial region of the face.  Measurements in terms of dermis thickness and echogenicity (Dermascan® C), skin color - *b parameter (Skin-Colorimeter CL 400) and morphological characterization of epidermis were performed. The evaluated parameters in the RCM were the epidermis thickness and qualitative analyses of the collagen and morphological epidermis pattern.  The skin of the diabetic participants had a lower echogenicity (p <0.05) when compared to the nondiabetic participants, but the dermis thickness did not present significant difference. The b* parameter was significantly different between both groups, suggesting that due to increased glycation in diabetics leads to an increase of yellow pigments, resulting in a more a yellowish skin when compared to healthy subjects. According to the RCM images analyses the skin of diabetic subjects showed lower epidermis thickness when compared with the skin of healthy subjects.  The collagen analysis score was worst for the diabetic group, which also presented more polycyclic papillae. Finally, this study showed the morphological and structural differences between normal and diabetics skin by a non-invasive way, applying the advanced biophysical and skin imaging techniques, such as RCM.

Clinical evaluation of diabetic women skin using biophysical skin imaging techniques