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This quiz tests your diagnostic skills for leg ulceration.
For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately 2 minutes to complete. There is a list of suggested further reading material at the end of the quiz.
When you finish the quiz, you can download a certificate.
What is the diagnosis?
Neuropathic ulceration
What are the predisposing factors?
Minor trauma in a patient that has underlying diabetes mellitus, which has resulted in neuropathy and arteriolar ischaemia.
What are the clinical features of this condition?
Diabetes accounts for 15-25% of leg ulcers, and for the majority of chronic foot ulcers. Symptoms of sensory neuropathy include pain, paraesthesia and anaesthesia. Signs include:
In response to pressure, the skin of the sole, toe or heel increases in thickness (callus) but with a minor injury breaks down and ulcerates. The most common sites are the soles, metatarsal head, great toe (bunion) or heel. These ulcers are frequently secondarily infected.