Showing posts with label diabetic foot ulcer. Show all posts
Showing posts with label diabetic foot ulcer. Show all posts
Does Your Dermatologist Check Your Feet?
Cancerous skin lesions can develop anywhere that there is skin. Sounds obvious, right? Many well trained dermatologists concentrate their examinations of the skin on areas that get the most sun exposure. You don't have to have alot of sun exposure to develop basal cell carcinoma, squamous cell carcinoma, or malignant melanoma. There is no way to know for sure that a skin lesion is or is not cancer. A clinical exam can give a high degree of probability one way or another, but the pathologist that looks at the lesion under a microscope is the one that decides what it truly is. We perform biopsies and excisions of skin lesions or masses on a regular basis. The great majority of the time this can be done in the office under simple local anesthesia. The specimen is then sent to a lab where the dermatopathologists(pathologists that concentrate on skin lesions) give the final diagnosis. Some times a deeper or wider excision is needed in order to get a border that is free of cancer cells, but most of the time the lesion is removed and the localized condition resolved. We give peace of mind to many people concerned about these lesions. Call our office for an evaluation and exam if you or a loved one may have a questionable skin lesion on your lower extremities.
The Diabetic Foot Problem
The Diabetic Foot Problem
Thousands of leg or foot amputations are performed each year due to complications of diabetes. Very often this is a result of an open sore or ulcer on the foot that goes unchecked and subsequently becomes infected. You may ask why would someone not tend to an open sore. Wouldn’t that be painful, especially on the foot? Well, surprising to most, most of the time there is no sensation in these areas at all. This is one of the most common complications of diabetes…diabetic neuropathy. Neuropathy can present with many different diseases or syndromes, but it is often closely associated with diabetes due to its prevalence.
Diabetic neuropathy can present as a burning, tingling, pins and needles sensation (like when your arm falls asleep) or a more intensified painful feeling. When diabetics get into trouble, though, is when the neuropathy presents as numbness. It creeps up on them and they often times don’t know it is happening until they notice some drainage on their sock from a sore that they were not aware of. If the foot is numb, then the patient cannot experience pain, and therefore does not stop to check out what the problem is because they don’t realize that, for example there is a toothpick stuck in their foot or they have walked so much that the callus that has developed from wear and tear has broken down underneath. Unless they have a loved one checking their feet for them on a regular basis then this may go unnoticed for a long period of time. An ulceration will then often become infected. If the infection lingers it can eventually involve the bone. When bone becomes infected, IV antibiotics and often amputation of part or all of that bone or area must be performed to rid the body of the infection. The 5-year survival rate for all lower extremity amputation patients is less than 50%! This is a staggering statistic.
This is why education of diabetics is so important. Prevention of infections and amputations improves quality of life for the patient and the family. Too often the diabetic patient with neuropathy and an ulceration has the mindset of "It doesn't hurt, so it must not be THAT serious." Herein lies the problem. As practitioners it is our job to relay the gravity of this situation and its very realistic potential of significantly shortening the patient's life if they don't come to grips with their problem.
If you have a friend or family member with Type 1 or Type 2 Diabetes please make sure they are properly educated on their disease state. Look for some signs that they may have neuropathy. If you are riding in the car with them and they are not so great at applying the brakes or gas smoothly it's probably because they cannot tell how much pressure they are applying to the pedal. When they walk if they have a little bit of a slap when there foot hits the ground its something they are probably doing subconsciously because they aren't able to feel their foot hit the floor, so they can at least hear it. This sounds strange to us, but it is reality for many diabetics.
Thousands of leg or foot amputations are performed each year due to complications of diabetes. Very often this is a result of an open sore or ulcer on the foot that goes unchecked and subsequently becomes infected. You may ask why would someone not tend to an open sore. Wouldn’t that be painful, especially on the foot? Well, surprising to most, most of the time there is no sensation in these areas at all. This is one of the most common complications of diabetes…diabetic neuropathy. Neuropathy can present with many different diseases or syndromes, but it is often closely associated with diabetes due to its prevalence.
Diabetic neuropathy can present as a burning, tingling, pins and needles sensation (like when your arm falls asleep) or a more intensified painful feeling. When diabetics get into trouble, though, is when the neuropathy presents as numbness. It creeps up on them and they often times don’t know it is happening until they notice some drainage on their sock from a sore that they were not aware of. If the foot is numb, then the patient cannot experience pain, and therefore does not stop to check out what the problem is because they don’t realize that, for example there is a toothpick stuck in their foot or they have walked so much that the callus that has developed from wear and tear has broken down underneath. Unless they have a loved one checking their feet for them on a regular basis then this may go unnoticed for a long period of time. An ulceration will then often become infected. If the infection lingers it can eventually involve the bone. When bone becomes infected, IV antibiotics and often amputation of part or all of that bone or area must be performed to rid the body of the infection. The 5-year survival rate for all lower extremity amputation patients is less than 50%! This is a staggering statistic.
This is why education of diabetics is so important. Prevention of infections and amputations improves quality of life for the patient and the family. Too often the diabetic patient with neuropathy and an ulceration has the mindset of "It doesn't hurt, so it must not be THAT serious." Herein lies the problem. As practitioners it is our job to relay the gravity of this situation and its very realistic potential of significantly shortening the patient's life if they don't come to grips with their problem.
If you have a friend or family member with Type 1 or Type 2 Diabetes please make sure they are properly educated on their disease state. Look for some signs that they may have neuropathy. If you are riding in the car with them and they are not so great at applying the brakes or gas smoothly it's probably because they cannot tell how much pressure they are applying to the pedal. When they walk if they have a little bit of a slap when there foot hits the ground its something they are probably doing subconsciously because they aren't able to feel their foot hit the floor, so they can at least hear it. This sounds strange to us, but it is reality for many diabetics.
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