AACE Conference Coverage

Skin and Ulcer Findings in Patients With Endocrine Disorders

Miranda Manier, BA

Key Highlights:

  • 72% of patients had skin manifestations; most common were acanthosis nigricans (34%), diabetic dermopathy (22%), and xerosis (20%).
  • Diabetic foot ulcers were present in 28% of patients and significantly associated with poor glycemic control (P < .001).
  • PRP therapy resulted in a 65% improvement in wound healing rates compared to standard care (P < .01).
  • Patients with insurance had improved access to advanced therapies and better outcomes.

A study presented at the American Association of Clinical Endocrinology (AACE) Annual Meeting in Orlando, FL, found that skin manifestations and diabetic wound ulcers are highly prevalent among patients with endocrine disorders in Nepal and are associated with significant impairment in quality of life. Among the interventions evaluated, platelet-rich plasma (PRP) therapy resulted in a 65% improvement in wound healing rates compared to standard care (P < .01). Patients enrolled in Nepal’s national insurance-free healthcare program had improved access to advanced therapies and better clinical outcomes.

Endocrine disorders, particularly diabetes mellitus, have become an increasingly urgent public health concern in Nepal. These conditions frequently lead to dermatological complications and diabetic wound ulcers, which significantly reduce patients' quality of life. Despite the high burden, there is a lack of epidemiological data and limited access to treatments such as PRP therapy in the country.

This mixed-methods study was conducted among 120 patients with diabetes mellitus and other endocrine disorders. Clinical examination was used to identify and classify skin lesions and wound ulcers. Quality of life was assessed using culturally adapted versions of the Dermatology Life Quality Index (DLQI), WHOQOL-BREF, and Wound-QoL questionnaires. A subgroup of patients with chronic diabetic ulcers received PRP therapy, with wound healing monitored over a 12-week period.

Skin manifestations were present in 72% of patients, with acanthosis nigricans (34%), diabetic dermopathy (22%), and xerosis (20%) reported most frequently. Diabetic foot ulcers were present in 28% of patients and were significantly associated with poor glycemic control (P < .001). Patients with skin manifestations and ulcers reported lower Wound QoL scores (DLQI: 14.2 ± 4.5; Wound-QoL: 58.3 ± 12.4) compared with those without such complications (DLQI: 4.1 ± 2.8; Wound-QoL: 82.1 ± 8.6; P < .001). PRP therapy showed a 65% improvement in wound healing rates versus standard care (P < .01). Patients with insurance had improved access to care and advanced therapies.

“Skin manifestations and diabetic wound ulcers are highly prevalent in Nepal, significantly impairing QoL,” the study authors concluded. “PRP therapy demonstrates promise as a cost-effective intervention for chronic wound healing in resource-limited settings.”

Reference

Bilal A, Wu A, Rosenberg B, et al. Epidemiology of skin manifestations and wound ulcers in endocrine disorders: Evaluating PRP therapy and the impact of Nepal’s national insurance-free healthcare on patient outcomes and quality of life. Talk presented at: American Association of Clinical Endocrinology Annual Meeting; May 15–17, 2025; Orlando, FL. Accessed May 7, 2025. https://annualmeeting.aace.com