Is dry skin a clue to diabetic retinopathy? Clinical insights from the overall dry skin score

Background: Fluctuations in blood sugar and changes in water retention mechanisms in diabetes mellitus often cause dry skin in patients with diabetes. However, the impact of diabetes on skin health has often been overlooked in clinical practice. Aims: This study aimed to investigate the relationship between diabetic complications and skin dryness as measured by the Overall Dry Skin (ODS) score. Methods: This single-center cross-sectional study included 100 patients with type 2 diabetes mellitus. Skin dryness was assessed on the forearm and lower leg using the ODS score, and diabetic complications were abstracted from medical records. Group comparisons and multivariable analyses were performed to identify factors independently associated with total ODS score. Results: The forearm, lower leg, and total ODS scores were significantly higher in patients with diabetic complications compared with those without complications (p < 0.05). The forearm ODS score was significantly higher in patients with retinopathy (p = 0.003) and peripheral polyneuropathy (p = 0.017). The ODS lower leg score was significantly higher in patients with retinopathy (p = 0.007). The total ODS score was significantly higher in patients with retinopathy (p = 0.002), nephropathy (p = 0.047), and peripheral polyneuropathy (p = 0.027). In multivariable analysis, only age (p = 0.002) and retinopathy (p = 0.042) were independently associated with total ODS score. Conclusions: These findings suggest that the Overall Dry Skin score may serve as a simple, non-invasive adjunctive clinical tool for identifying patients at higher risk of diabetic retinopathy in routine clinical practice. Prospective, multicenter studies with larger sample sizes are warranted to confirm the predictive value of ODS scoring.