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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.
 

Skin Changes of the Leg

 
 

Overview

  • Skin changes and overall poor skin condition of the lower limb may occur due to soft tissue disease; arterial, venous or lymphatic insufficiency; loss of afferent nerve supply or simply poor self-care.

Venous Skin Changes

    • Look For

    • Oedema
    • Venous eczema
    • Hyperpigmentation
    • White scar tissue (atrophie blanche)
    • Induration - fibrosis of subcutaneous fat (lipodermatosclerosis)
    • Significance

    • Venous insufficiency.
    • Causes of Venous Skin Changes

    • Venous hypertension due to incompetent valves
    • Venous outflow obstruction
    • Calf-muscle pump failure - obesity, immobility

Arterial Skin Changes

    • Look For

    • Absent pedal pulses
    • Thin / shiny skin
    • Cool skin
    • Hair loss
    • Significance

    • Partial or complete arterial occlusion.
    • Causes of Arterial Skin Changes

    • Atherosclerosis
    • Diabetes
    • Thromboangiitis
    • Vasculitis

Overview

  • The term trophic derives from the Greek trophe, meaning 'nourishment'.
Last updated on December 1st, 2019
 
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