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Diabetic Exam
 
 
 
 
Diabetic Exam
Poor diabetic control may manifest in many different ways, with macrovascular and microvascular complications. The diabetic examination is useful for diagnosing these complications, particularly when it comes to the vascular and neurologic examination of the lower limb.
 

Nail Inspection

 
 

Overview

  • Diabetics often exhibit onycholysis of the nails, and poor diabetic control can lead to increased infection risk and paronychias.

Onycholysis

    • Look For

    • Separation of the nail from the nail bed, either distally or laterally.
    • Causes of Onycholysis

    • Systemic disease - chronic kidney disease, bronchial carcinoma, anaemia, diabetes mellitus, porphyrias, peripheral vascular disease, thyrotoxicosis
    • Nail infection - fungal, bacterial
    • Skin disease - psoriasis, dermatitis, lichen planus
    • Trauma

Paronychia

    • Look For

    • Erythema and swelling of the skin around the fingernails, which may be associated with pus from the nail fold.
    • Significance

    • Infection, usually due to Staphylococcus, Streptoccocus or sometimes Herpes simplex.
    • Predisposing Factors

    • Ingrown nail
    • Artificial nails
    • Manicuring
    • Habitual nail biting
Last updated on November 28th, 2019
 
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