​Dermatology - Diabetic Neuropathy

​Dermatology - Diabetic Neuropathy
The condition known as peripheral neuropathy is the underlying cause of the condition commonly referred to as the "diabetic foot." Additional variables include angiopathy, atherosclerosis, and infection, which are frequently observed in combination. Diabetic neuropathy is a condition that affects both the motor and sensory functions. Motor neuropathy specifically causes weakness and muscle deterioration in the extremities.


The onset of sensory loss initiates in the toes and gradually advances throughout the legs. Sensations of tingling, burning, and intense aching may also be evident.
Abnormalities
The patient's sensory neuropathy increases their susceptibility to developing neurotropic ulcers on bony prominences of the feet, typically on the great toe and sole as depicted. The ulcers are encircled by a band of thickened skin and can spread to the underlying joint and bone, resulting in osteomyelitis.

Nerve conduction examinations typically demonstrate decreased amplitudes and considerable slowing of conduction velocities. Nerve biopsy indicates degeneration of the axons, increased growth of endothelial cells, and sometimes inflammation around blood vessels.


Strict regulation of glucose levels might decrease the likelihood of developing neuropathy or enhance the existing neuropathy. All infections should be managed with suitable antibiotic agents.
The management of pain can involve the use of antiepileptics, antidepressants, sodium channel blockers, and other analgesics. Ulcers should undergo debridement, followed by the application of moist wound treatment, protective dressings, and off-loading, typically involving nonweight bearing.