Examine the lower or supper limbs of this diabetic patient.
Proceed as follows :
Inspection :
★Necrobiosis lipoidica diabeticorum (central yellow scar with surrounding red margin, found over the shins due to atrophy of subcutaneous collagen)★Ulceration and infection (boil, abscess,gangrene, carbuncle and cellulities) Look at the sole and between the toes.
★Diabetic dermopathy (small rounded plaques with raised border over the shins in a linear orientation). Look for any pigmentation scars (late diabetic dermopathy)
★Injection mark on thaighs and fat atrophy or hypertrophy.
★Hair loss and skin atrophy (found in small vessel disease)
★Muscle wasting (due to neuropathy or diabetic amyotrophy or as a part of Generalized wasting)
★Examine both knee joint(swollen joints deformity indicates Charcot joints)
Palpation :
★Temperature (may be cold and blue due to peripheral vascular diseases and associated skin atrophy or absent pulse)★Pulsation(absent due to peripheral vascular disease or atherosclerosis)and bounding pulse (in neuropathy)
★Pitting oedema.
3)Auscultate over femoral artery (for bruit)
4)Perform neurological examination of lower limbs.
★★★Next Coming..."" Examination of eye in diabetic persone"".
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