Differentiating obesity with and without prediabetes through skin findings: results from PREVIEW sub-study

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Horseshoe-like plantar hyperkeratosis (HSLPH) was significantly more prevalent in adults with prediabetes compared to those without.
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The presence of HSLPH was associated with higher odds of prediabetes, with an odds ratio of 3.03.
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HSLPH demonstrated high specificity (90%) but low sensitivity (25%) as a clinical sign for prediabetes.
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Other common skin conditions, such as skin tags and onychomycosis, were not associated with prediabetes in this cohort.
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The study suggests HSLPH may serve as a visible clinical indicator for metabolic evaluation in overweight or obese adults.

Frontiers In Endocrinology

by Razvigor Darlenski, Vesselina Mihaylova, Karen Manuelyan, Denitza Zheleva, Georgi Bogdanov, Ivan Bogdanov, Todor Kundurzhiev, Pavlina Gateva, Mikael Fogelholm, Anne Raben, Teodora Handjieva-Darlenska
April 1, 2026

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