Photoessay: The Skin and Diabetes Mellitus
by A Huntley
Dermatology Online Journal, December 1995
Volume 1, Number 2
Diabetic Neuropathy of the Foot
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sensory neuropathy
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motor neuropathy
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Charcot foot
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additional images of neuropathy
sensory neuropathy
Another major complication of diabetes mellitus is development of neuropathy.
Relative to the skin, the most common manifestations involve legs and feet.
Sensory neuropathy allows trauma to occur to the feet from ill-fitting shoes
which may then result in ulceration.
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Figs 31,32. Two illustrations of diabetic sensory neuropathy of the foot.
The affected foot on the left has callus and ulcer on the distal aspect of the
right second toe. The patient was unaware of the ulcer. The foot of the
diabetic patient shown on the right has multiple erosions on the dorsal aspect
of the toes. The patient was unable to feel the trauma which initiated these
wounds.
motor neuropathy
Motor neuropathy results in weakened intrinsic foot muscles. The toes dorsiflex
and the foot splays (becomes wider) on weight -bearing. This new shape may no
longer fit the previous shoes and, along with sensory neuropathy, may potentiate
trauma and ulceration.
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Fig 33. Foot of diabetic patient with motor neuropathy. Note that the toes
are being drawn upward.
Charcot foot
With loss of sensation and weak intrinsic muscles, the foot may fracture when
stressed. Multiple fractures allowed to heal without realignment result in the
distortion of shape.
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Fig 34. Foot of a diabetic patient who has sensory and motor neuropathy. She
started to run bare foot and heard the snapping sound in her feet . The foot
was allowed to heal without medical intervention.
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additional images of foot neuropathy
All contents copyright (C), 1995.
Dermatology Online Journal
University of California Davis
