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What Do Diabetic Ulcers Look Like?

Everything You Should Know About Diabetic Blisters

Everything You Should Know About Diabetic Blisters

If you have diabetes and experience the spontaneous eruption of blisters on your skin, they may well be diabetic blisters. These are also called bullosis diabeticorum or diabetic bullae. Although the blisters may be alarming when you first spot them, they’re painless and normally heal on their own without leaving scars. A number of skin conditions are associated with diabetes. Diabetic blisters are fairly rare. An article in the International Journal of Diabetes in Developing Countries notes that in the United States, the disorder occurs in only 0.5 percent of people with diabetes. Diabetic blisters are twice as likely to be found in men than in women. Diabetic blisters most often appear on your legs, feet, and toes. Less frequently, they show up on hands, fingers, and arms. Diabetic blisters can be as large as 6 inches, though they’re normally smaller. They’re often described as looking like blisters that occur when you get a burn, only without the pain. Diabetic blisters seldom appear as a single lesion. Rather, they are bilateral or occur in clusters. The skin surrounding the blisters isn’t normally red or swollen. If it is, see your doctor promptly. Diabetic blisters contain a clear, sterile fluid, and they’re usually itchy. Read about the eight best remedies for itching. Given the risk of infection and ulceration when you have diabetes, you may want to see a dermatologist to rule out more serious skin conditions. Diabetic blisters usually heal in two to five weeks without intervention, according to an article in Clinical Diabetes. The fluid in the blisters is sterile. To prevent infection, you shouldn’t puncture the blisters yourself, though if the lesion is large, your doctor may want to drain the fluid. This will keep the skin intact as a covering for Continue reading >>

Diabetic Foot Ulcer

Diabetic Foot Ulcer

What is a diabetic foot ulcer? Diabetic foot ulcers are sores on the feet that occur in 15% of diabetic patients some time during their lifetime. The risk of lower-extremity amputation is increased 8-fold in these patients once an ulcer develops. They occur in type 1 and in type 2 diabetes mellitus. What causes a diabetic foot ulcer? A diabetic foot ulcer is caused by neuropathic (nerve) and vascular (blood vessel) complications of diabetes. Nerve damage due to diabetes causes altered or complete loss of feeling in the foot and/or leg. This is known as peripheral neuropathy. Pressure from shoes, cuts, bruises, or any injury to the foot may go unnoticed. The loss of protective sensation stops the patient from being warned that the skin is being injured and may result in skin loss, blisters and ulcers. Vascular disease is also a major problem in diabetes and especially affects very small blood vessels feeding the skin (microangiopathy). In this situation a doctor may find normal pulses in the feet because the arteries are unaffected. However other diabetic patients may also have narrowed arteries so that no pulse can be found in the feet (ischaemia). The lack of healthy blood flow may lead to ulceration. Wound healing is also impaired. Vascular disease is aggravated by smoking. What are the signs and symptoms of diabetic foot ulcer? It is not unusual for patients to have had diabetic foot ulcers for some time before presenting to a health professional, because they are frequently painless. Depending on severity, a diabetic foot ulcer may be rated between 0 and 3. 0: at risk foot with no ulceration 1: superficial ulceration with no infection 2: deep ulceration exposing tendons and joints 3: extensive ulceration or abscesses Tissue around the ulcer may become black due to t Continue reading >>

Leg Sores: Symptoms & Signs

Leg Sores: Symptoms & Signs

Leg sores can arise from trauma, infection, tumors, or chronic medical conditions. Any process of inflammation or tissue damage can manifest as a sore on the leg. Leg sores may affect primarily the skin or can extend into the subcutaneous tissues, muscles, bone, and deeper structures of the leg. Depending upon the exact cause, they may be associated with redness, swelling, oozing, crusting, ulceration, and Common causes of leg sores include insect bites and stings, cuts and abrasions, and skin infections. REFERENCE: Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015. Pictures, Images, Illustrations & Quizzes Causes of Leg Sores Continue reading >>

Diabetic Foot Ulcers

Diabetic Foot Ulcers

Diabetic foot ulcers can be divided into two groups: those in neuropathic feet (so called neuropathic ulcers) and those in feet with ischaemia often associated with neuropathy (so called neuroischaemic ulcers). The neuropathic foot is warm and well perfused with palpable pulses; sweating is diminished, and the skin may be dry and prone to fissuring. The neuroischaemic foot is a cool, pulseless foot; the skin is thin, shiny, and without hair. There is also atrophy of the subcutaneous tissue, and intermittent claudication and rest pain may be absent because of neuropathy. The crucial difference between the two types of feet is the absence or presence of ischaemia. The presence of ischaemia may be confirmed by a pressure index (ankle brachial pressure index < 1). As many diabetic patients have medial arterial calcification, giving an artificially raised ankle systolic pressure, it is also important to examine the Doppler arterial waveform. The normal waveform is pulsatile with a positive forward flow in systole followed by a short reverse flow and a further forward flow in diastole, but in the presence of arterial narrowing the waveform shows a reduced forward flow and is described as “damped.” Continue reading >>

What Does A Foot Ulcer Look Like? An Indianapolis Podiatrist Answers

What Does A Foot Ulcer Look Like? An Indianapolis Podiatrist Answers

As a Indianapolis podiatrist that specializes in diabetic foot care and wound care, I often get asked by patients as well as by family & friends, what does a foot ulcer look like? And why do people with diabetes develop foot ulcers? A foot ulcer is an open sore. These can be superficial such as a blister that has opened with underlying pink raw tissue exposed or an ulcer can be deep and extend down to the bone. Some ulcers are infected and drain heavily while some have very little or no drainage. An ulcer may or may not be painful. People develop foot ulcers for many different reasons and you don’t need to have diabetes to develop a foot ulcer. Pressure, trauma, and poor circulation can all lead to foot ulcers. A diabetic with a red open sore on the bottom of their foot generally surrounded by a callus has a diabetic foot ulcer. A diabetic foot ulcer, also called a neuropathic ulcer, occur most often on the bottom of the foot over a bony prominence. Ulcers can also develop on the sides of the foot or tops of the toes from friction and pressure of shoes or from poor circulation. For example, a person with diabetes develops a callus on the bottom of their foot. A callus is a build-up of skin due to increased pressure on the foot. Left untreated or, often when self-treated, the callus becomes infected or breaks down into an ulcer. The callus and the eventual ulcer many times go left untreated because a diabetic patient lacks feeling called neuropathy and is unaware that the ulcer is present. This is why you often hear that diabetics should check their feet daily and see a foot doctor routinely. Or the person may be aware of the ulcer but because it is not painful they do not seek immediate treatment. Once an ulcer is discovered it is imperative that professional treatmen Continue reading >>

10 Diabetic Skin Problems

10 Diabetic Skin Problems

1 / 11 Are You Suffering From a Diabetes-Related Skin Complication? About a third of people with diabetes will develop skin problems at some point. In fact, some skin issues can be warning signs of diabetes. The good news is that most skin conditions can be treated easily if they’re caught early. Keeping proper control of your blood sugar (glucose) can prevent skin problems and many other diabetes symptoms from happening in the first place. “For the most part, control of diabetes can help with related skin issues,” says Justin Ko, MD, the medical director and service chief of medical dermatology at Stanford Health Care, in Redwood City, California. “I’m always adamant that my diabetic patients take aggressive care of their skin and health in general. For the skin, moisturization, checking feet and legs daily for any blisters, sores, and skin breaks (especially between the toes), and nail care is extremely important. Nail and foot fungus can lead to skin cracks and breaks, allowing bacteria to enter and cause infection.” Continue reading >>

Prevention And Treatment Of Leg And Foot Ulcers In Diabetes Mellitus

Prevention And Treatment Of Leg And Foot Ulcers In Diabetes Mellitus

Definition An ulcer is defined as a breakdown in the skin that may extend to involve the subcutaneous tissue or even to the level of muscle or bone. These lesions are common, particularly on the lower extremities. Leg and foot ulcers have many causes that may further define their character. Prevalence The prevalence of leg ulceration is approximately 1% to 2%, and is slightly higher in the older adult population.1 Venous ulcers are the most common form of leg ulcers, accounting for almost 80% of all lower extremity ulcerations.2 Peak prevalence is between 60 and 80 years.3 Approximately one third of patients with chronic venous insufficiency will develop venous ulceration before the age of 40 years.2 In addition, venous ulcers may have a prolonged duration and are associated with a high rate of recurrence, which contributes to their prevalence. Ulcerations associated with diabetes are the most common cause of foot ulcers. Most of these ulcers are a direct result of loss of sensation secondary to peripheral neuropathy. Approximately 15% of persons with diabetes will develop foot ulceration during their lifetime.4 Most lower extremity amputations in the United States are preceded by a foot ulcer.5 Arterial ulcers account for 10% to 20% of lower extremity ulcerations. Other causes of lower extremity ulceration are uncommon. Many ulcers may be of mixed cause, with two or more contributing factors leading to ulceration present in the same patient. We focus on the most common causes of ulceration. Pathophysiology Neurotrophic Ulcers The development of neurotrophic foot ulcers in patients with diabetes mellitus has several components, including neuropathy, biomechanical pressure, and vascular supply. Peripheral neuropathy is clearly the dominant factor in the pathogenesis of d Continue reading >>

Skin Problems In Diabetes

Skin Problems In Diabetes

If you have diabetes, it’s important to be aware of potentially serious skin problems related to the disease and see your doctor before the problem gets out of control. In most cases, skin problems in diabetes can be managed with early diagnosis and treatment. you might like Scleroderma diabeticorum: While rare, this skin problem affects people with type 2 diabetes, causing a thickening of the skin on the back of the neck and upper back. The treatment is to bring your blood sugar level under control. Lotions and moisturizers may help soften skin. Vitiligo: Vitiligo, a skin problem more commonly associated with type 1 diabetes than type 2 diabetes, affects skin coloration. With vitiligo, the special cells that make pigment (the substance that controls skin color) are destroyed, resulting in patches of discolored skin. Vitiligo often affects the chest and abdomen, but may be found on the face around the mouth, nostrils, and eyes. Current treatment options for vitiligo include topical steroids and micropigmentation (tattooing). If you have vitiligo, you should use sunscreen with an SPF of 30 or higher to prevent sunburn on the discolored skin. Acanthosis nigricans. This is a skin problem that results in the darkening and thickening of certain areas of the skin especially in the skin folds. The skin becomes tan or brown and is sometimes slightly raised and described as velvety. Most often the condition, which typically looks like small warts, appears on the sides or back of the neck, the armpits, under the breast, and groin. Occasionally the top of the knuckles will have a particularly unusual appearance. Acanthosis nigricans usually strikes people who are very overweight. While there is no cure for acanthosis nigricans, losing weight may improve the skin condition. Acant Continue reading >>

What Does A Foot Ulcer Look Like?

What Does A Foot Ulcer Look Like?

A foot ulcer, or lower extremity ulcer, is an open wound on the foot, heel or even between the toes. It isn't always a painful condition -- sometimes the person with the ulcer only feels a burning, itching or tight sensation where the ulcer is occurring. Without treatment, however, an ulcer on the foot can lead to abscesses and gangrene. Some have even led to amputation. Types There are three types of foot ulcers: venous stasis ulcers, which are the most common type, arterial and neurotrophic ulcers, which are caused by diabetes. According to the Cleveland Clinic, about 90 percent of ulcers are venous stasis. Arterial are typically the most painful. Identification Each type of ulcer looks a bit different. Venous stasis ulcers are usually found around the ankle area, can appear red, and have an asymmetrical shape. They also may drain out fluid. The skin around the ulcer may feel hot, according to the Cleveland Clinic. Arterial ulcers occur on the foot, even on the toes, and may not bleed. Neurotrophic ulcers occur on the bottom of the feet, and may appear pink or even black, depending on the condition of the ulcer. Amazingly, some people with neurotrophic ulcers may not even realize they have one, which makes them even more dangerous, because they can often become very infected before any treatment begins. Causes There are many causes of foot ulcers. Diabetes is a major culprit behind the development of foot ulcers. Patients with bad circulation in the lower part of their body are also at a risk. There are other diseases that can cause ulcers as well, including renal failure and inflammatory diseases. Genetics also plays a part in foot ulcers. Dr. Jefferey Johnson, MD, said in a October 31, 2005 interview that about 15 percent of people with diabetes will, at some point, Continue reading >>

What Do Diabetic Sores Look Like?

What Do Diabetic Sores Look Like?

Having diabetes can be a serious medical condition, especially when the disease is left unmanaged. Sores (ulcers) in diabetics usually appear upon your feet. Even the slightest cut or blister development upon your foot can result in a serious and dangerous complication. Without proper treatments, skin conditions such as sores can result in amputations of your toes, foot, or leg. Early Detection According to the American Diabetes Association, up to 33 percent of diabetic sufferers will suffer from some form of skin complication as a result of the disease. The development of a skin complication may even be an indicator that diabetes is present. It is important to seek immediate medical attention if an ulcer is developing to prevent further damage to your lower extremities. Signs An ulcer can easily develop due to neuropathy damage. According to the Mayo Clinic, neuropathy or nerve damage, occurs when your blood vessels become injured. As a result of neuropathy, your feet can't detect pain anymore; which makes the development of a cut, callus, or crack upon your foot dangerous. Early signs of neuropathy include tingling sensations, numbing of your feet, or burning, and pain. It is important that if you're diabetic, to pay close attention to your feet, especially if a wound develops. Diabetic Ulcers An ulcer upon your feet will usually begin to develop on the areas that receive the most pressure, such as the bottom of your foot. However, an ulcer can develop anywhere upon your foot, especially when you have an impaired feeling of your affected foot. The coloration of an ulcer can either be pinkish red, or brownish black. You may notice that the border of your ulcer is puffed, while the skin around the ulcer is severely callused. Wound Care Treating an ulcer will require for Continue reading >>

Diabetic Ulcer (neurogenic Ulcer)

Diabetic Ulcer (neurogenic Ulcer)

Images of Neurogenic Ulcer (Diabetic Ulcer) (3) Overview Neurogenic ulcers, also known as diabetic ulcers, are ulcers that occur most commonly on the bottom of the foot. People with diabetes are predisposed to peripheral neuropathy, which involves a decreased or total lack of sensation in the feet. Feet are naturally stressed from walking, and someone who has decreased sensation will not necessarily feel that they have an area of skin breakdown occurring. Coupled with this lack or absence of sensation is a decrease in circulation to the feet as well. Wounds that do not get proper blood flow are not only slower to heal but also at an increased risk for infection. A small cut, scrape, or irritated area in a diabetic can turn into an ulcer for these reasons. It is common for these types of ulcers to keep coming back in diabetics. Who's at risk? Approximately 15% of diabetics will be affected by neurogenic ulcers. The more serious or severe a person's diabetes is and the more out of control or higher his/her blood sugar is, the more likely he/she is to develop ulcers. Other risk factors include obesity, heart disease, and tobacco use. While neurogenic ulcers most often occur in diabetics, any condition resulting in peripheral neuropathy will predispose a person to getting them. Signs and Symptoms An ulcer is an open wound that can be deep enough that you can see down to the bone. Diabetic foot ulcers commonly occur on the pressure points of the foot: the ball, heel, and side of the foot if a person's shoes are too tight. However, an ulcer can form in any location that gets cut or scraped if it fails to heal properly. Self-Care Guidelines The key is to prevent ulcers from forming: Inspect feet daily, including the areas between the toes, to look for any breaks in the skin; b Continue reading >>

Diabetic Foot Pain And Ulcers: Causes And Treatment

Diabetic Foot Pain And Ulcers: Causes And Treatment

Foot ulcers are a common complication of poorly controlled diabetes, forming as a result of skin tissue breaking down and exposing the layers underneath. They’re most common under your big toes and the balls of your feet, and they can affect your feet down to the bones. All people with diabetes can develop foot ulcers and foot pain, but good foot care can help prevent them. Treatment for diabetic foot ulcers and foot pain varies depending on their causes. Discuss any foot pain or discomfort with your doctor to ensure it’s not a serious problem, as infected ulcers can result in amputation if neglected. One of the first signs of a foot ulcer is drainage from your foot that might stain your socks or leak out in your shoe. Unusual swelling, irritation, redness, and odors from one or both feet are also common early symptoms of a foot ulcer. The most visible sign of a serious foot ulcer is black tissue (called eschar) surrounding the ulcer. This forms because of an absence of healthy blood flow to the area around the ulcer. Partial or complete gangrene, which refers to tissue death due to infections, can appear around the ulcer. In this case, odorous discharge, pain, and numbness can occur. Signs of foot ulcers are not always obvious. Sometimes, you won’t even show symptoms of ulcers until the ulcer has become infected. Talk to your doctor if you begin to see any skin discoloration, especially tissue that has turned black, or feel any pain around an area that appears callused or irritated. Your doctor will likely identify the seriousness of your ulcer on a scale of 0 to 3 using the following criteria: 0: no ulcer but foot at risk 1: ulcer present but no infection 2: ulcer deep, exposing joints and tendons 3: extensive ulcers or abscesses from infection Diabetic ulcers a Continue reading >>

How To Spot And Treat Common Diabetic Foot Ulcer Symptoms

How To Spot And Treat Common Diabetic Foot Ulcer Symptoms

If left untreated, diabetic foot ulcers can cause permanent damage that affects your mobility. Approximately 15% of people with diabetes suffer from foot ulcers, according to the American Podiatric Medical Association (APMA). Knowing how to recognize diabetic foot ulcer symptoms is crucial, because untreated ulcers can lead to permanent disfigurement. APMA reports that diabetic wounds are the leading cause of non-traumatic lower extremity amputations in the United States. However, proper wound care can help reduce the chances of surgical intervention, infection, and foot deformation. The following information will help you recognize wound symptoms and find an effective diabetic foot ulcer treatment. Causes Neuropathy occurs when blood vessels supplying nerves with oxygen and nutrients are damaged. The feet of a person with diabetes are particularly susceptible to neuropathy because of insufficient blood flow and unchecked blood sugar. These conditions can destroy nerve cells and cause pain, tingling, and numbness. People with diabetic neuropathy may lose enough sensation in their feet that they cannot feel the pain or the intense itching of foot injuries. Foot issues like ingrown toenails or dry skin cuts may go unnoticed unless you check your feet at least once a day for open wounds or other trauma. Diabetes also interferes with normal wound healing. Skin breaks on the feet are affected by diminished blood flow and the restriction of white blood cells that are needed to initiate the wound healing process. Symptoms Diabetic foot ulcers almost always form on the soles of the feet, where skin is subject to constant pressure. Under the weight of the body, skin deteriorates and eventually becomes an open sore. These ulcers frequently form underneath calluses and cannot be f Continue reading >>

Diabetes: 12 Warning Signs That Appear On Your Skin

Diabetes: 12 Warning Signs That Appear On Your Skin

Diabetes can affect many parts of your body, including your skin. When diabetes affects the skin, it’s often a sign that your blood sugar (glucose) levels are too high. This could mean that: You have undiagnosed diabetes, or pre-diabetes Your treatment for diabetes needs to be adjusted If you notice any of the following warning signs on your skin, it’s time to talk with your doctor. This skin condition often begins as small raised solid bumps that look like pimples. As it progresses, these bumps turn into patches of swollen and hard skin. The patches can be yellow, reddish, or brown. You may also notice: The surrounding skin has a shiny porcelain-like appearance You can see blood vessels The skin is itchy and painful The skin disease goes through cycles where it is active, inactive, and then active again The medical name for this condition is necrobiosis lipodica (neck-row-by-oh-sis lee-poi-dee-ka). TAKE ACTION Get tested for diabetes if you have not been diagnosed. Work with your doctor to better control your diabetes. See a dermatologist about your skin. Necorbiosis lipodica is harmless, but it can lead to complications. A dark patch (or band) of velvety skin on the back of your neck, armpit, groin, or elsewhere could mean that you have too much insulin in your blood. AN is often a sign of prediabetes. The medical name for this skin condition is acanthosis nigricans (ay-can-THOE-sis NIE-gri-cans). TAKE ACTION: Get tested for diabetes. 3. Hard, thickening skin When this develops on the fingers, toes, or both, the medical name for this condition is digital sclerosis (sclear-row-sis). On the hands, you’ll notice tight, waxy skin on the backs of your hands. The fingers can become stiff and difficult to move. If diabetes has been poorly controlled for years, it can f Continue reading >>

Diabetes And Wounds: Caring For Sores

Diabetes And Wounds: Caring For Sores

When you have diabetes, it's vital to treat foot injuries right away. Even minor wounds can turn into serious foot ulcers, which can cost you a foot -- or an entire leg -- if you don’t care for them quickly and thoroughly. These easy steps can prevent problems down the road. Common Causes What you put on your feet matters. "You can get a foot ulcer from something as simple as walking in new or tight-fitting shoes or getting a small pebble stuck in the shoe,” says Raul Guzman, MD, a vascular surgeon at the Joslin Diabetes Center in Boston. If you have diabetes, you may get a kind of nerve damage that stops the feeling in your feet. Doctors call this neuropathy. If you can’t feel your feet, you may not know you’re hurt, and a small cut or sore can turn into something bigger. Or you might have poor blood flow to your feet, which makes it hard for even minor cuts to heal. Your doctor can tell you whether you have nerve damage or blood-flow problems. Guzman says he can do a test that shows how blood moves through your body. If the results are normal, you can have standard wound-care treatments. “If the results of this blood-flow test are abnormal, that means you have poor circulation that needs to be repaired,” he says. Surgery can help. “We can use a balloon and stent,” Guzman says, “or we can do a bypass procedure, where we connect the artery above the blockage to one of the arteries in the calf or foot.” Wound Treatment Options If you do injure your foot, don't try to take care of it at home. Go to a wound-care center or your doctor, even for blisters, calluses, and scratches. “Put on some antibiotic ointment and see a wound center or your doctor, at the latest, the next day,” says Harold Brem, MD, chief of the wound healing and regenerative medici Continue reading >>

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