Bệnh nhân có hai vết loét bề mặt đau đớn trên các khía cạnh trung gian của bàn chân phải của mình do chấn thương từ giày dép của mình, lần đầu tiên ông nhận thấy 3 tháng trước đó. Ông đã sử dụng iốt povidone tại chỗ với sự cải thiện không. Các vết loét sạch sẽ mà không có dấu hiệu nhiễm trùng | Neuro-Ischemic Ulcers at Various Sites 113 Figure Neuro-ischemic ulcers on the hindfoot revealed significant diffuse stenoses mainly of the arteries in the left leg. The patient had two painful superficial ulcers on the medial aspect of his right foot due to trauma from his footwear which he first noticed 3 months earlier. He used topical povidone iodide with no improvement. The ulcers were clean without signs of infection. A mild callus had formed as a result of shoe friction. At the clinic the ulcers were debrided on a weekly basis and dressed with standard gauge with 15 saline. They healed completely in 1 month. Povidone iodide was discontinued as it impairs wound healing. Instruction in appropriate foot care and foot hygiene was provided and suitable footwear was prescribed. Neuro-ischemic ulcers comprise almost 40 of all diabetic foot ulcers. Ischemic ulcers develop at sites which are not stressed by high pressure such as the lateral medial or dorsal aspect of the foot and are usually painful. Intervention with vascular surgery bypass grafting or percutaneous transluminal angioplasty is usually needed in order to restore the blood supply to the periphery. Keywords Peripheral vascular disease neuro-ischemic foot ulcers pes planus NEURO-ISCHEMIC ULCER ON THE FIRST METATARSAL WITH OSTEOMYELITIS An ostensibly small painless neuro-isch-emic ulcer on the medial-plantar area of the first metatarsal head with callus formation and purulent discharge was the reason for this patient s visit Figure . Claw deformity of lesser toes was present. After debridement a X X cm ulcer was revealed. A plain radiograph showed osteomyelitis of the first metatarsal head. Staphylococcus aureus was isolated from 114 Atlas of the Diabetic Foot Figure An ostensibly small neuro-ischemic ulcer complicated by osteomyelitis. Claw deformity of lesser toes is also apparent the discharge and the patient was treated with clindamycin for 6 months with a good outcome. .
