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Pressure ulcers can trigger other ailments, cause considerable suffering, and can be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, bone infection, pyarthrosis, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin's ulcer – secondary carcinomas in chronic wounds).
Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
A callus (pl.: calluses) is an area of thickened and sometimes hardened skin that forms as a response to repeated friction, pressure, or other irritation. Since repeated contact is required, calluses are most often found on the feet and hands, but they may occur anywhere on the skin.
The pus comes out and a hole forms under which the lesion grows deeper. This leads to punched-out, painless ulcers usually under metatarsal heads, tip of toe, or proximal interphalangeal joint of a hammertoe or on the heel. [3] In non-ambulatory patients, these ulcers are found on buttocks and back of the heel. [citation needed]
Intrinsic atrophy of foot and ankle muscles leads to anatomic changes of the foot arch, most commonly depressing the metatarsal heads and creating high pressure zones. [8] Neuropathy is present in approximately 60% of patients who develop foot ulcers and are also diabetic. [ 4 ]
The current guideline in the United Kingdom recommends collecting 8-10 pieces of information for predicting the development of foot ulcers. [16] A simpler method proposed by researchers provides a more detailed risk score based on three pieces of information (insensitivity, foot pulse, previous history of ulcers or amputation).
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Foot of an 80-year old individual with type 2 diabetes and heart failure. The second toe has a large ischaemic ulcer. The first toe has a small one. The prevalence of arterial insufficiency ulcers among people with Diabetes is high due to decreased blood flow caused by the thinning of arteries and the lack of sensation due to diabetic neuropathy.