Critical assessment of diabetic xerosis.

INTRODUCTION: Diabetes mellitus is commonly responsible for skin changes including discrete to mild xerosis. AREAS COVERED: This review focuses on some selected relevant bioinstrumental methods assessing diabetes xerosis. Peer-reviewed articles on objective non-invasive methods were scrutinized. The reviewed methods address i) the xerosis severity grading scale, ii) corneodynamics referring to the desquamation rate, iii) electrometric assessment of skin hydration including skin capacitance mapping and iv) implication of the imperceptible perspiration. The subjective clinical assessment often fails to disclose diabetic xerosis with confidence and precision. By contrast, a multipronged biometrological approach identifies a cluster of diabetic patients who experience alterations in the structural and functional maturation of the stratum corneum. EXPERT OPINION: A multipronged biometrological approach helps identifying the changes in the stratum corneum of diabetic xerosis. There is a continuum between the 'dry skin' feeling, xerosis and ichthyosiform presentations, particularly on the shins and feet of diabetic patients.