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Thermographic findings in a case of type 2 diabetes with foot ulcer due to callus deterioration

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Abstract

Abstract

A number of studies have reported the usefulness of monitoring skin temperature at local points in reducing the risk of ulceration. Thermography has the advantage of being able to visualize morphological temperature distribution. We reported that inflammation was detected by thermography in 10% of diabetes mellitus (DM) patients with foot calluses, and the area in which increased skin temperature was observed was limited to the callus. However, no reports have described thermographic findings of calluses deteriorating into foot ulcers. We report a case monitoring the skin temperature distribution using thermography, which might be useful for predicting ulceration.

Case

A 53-year-old male patient, diagnosed with type 2 DM, was treated with insulin therapy. The duration of DM was 4 years. He was also diagnosed with dyslipidemia and hypertension. Using thermography, the skin temperature was evaluated in the patient with calluses on the 5th metatarsal heads. Areas of increased skin temperature were observed, involving not only the callused part, but also the plantar arch. We shaved his calluses once a month and explained the importance of his therapeutic shoes to prevent the ulcers. After 43 months, an ulcer developed.

Discussions

Thermographic findings of an extended area of increased skin temperature not limited to the callus may suggest the progression of a callus to ulcer. Expansion of the area of increased skin temperature might show the inflammation or infection extending along the fascia. Based on these findings, thermography could provide a useful assessment of callus in DM patients with a high risk of progression.

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Authors and Affiliations

  1. Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan

    Makoto Oe

  2. Department of Nursing Administration and Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan

    Kimie Takehara

  3. Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan

    Hiroshi Noguchi

  4. Department of Nursing, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan

    Yumiko Ohashi

  5. Department of Gerontological Nursing and Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan

    Ayumi Amemiya & Hiromi Sanada

  6. Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200, Kihara Kiyotake Town, Miyazaki-shi, Miyazaki, Japan

    Hideyuki Sakoda

  7. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan

    Ryo Suzuki, Toshimasa Yamauchi & Takashi Kadowaki

  8. Department of Molecular Sciences on Diabetes, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan

    Kohjiro Ueki

Authors
  1. Makoto Oe
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  2. Kimie Takehara
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  3. Hiroshi Noguchi
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  4. Yumiko Ohashi
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  5. Ayumi Amemiya
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  6. Hideyuki Sakoda
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  7. Ryo Suzuki
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  8. Toshimasa Yamauchi
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  9. Kohjiro Ueki
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  10. Takashi Kadowaki
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  11. Hiromi Sanada
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Corresponding author

Correspondence to Hiromi Sanada.

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Conflict of interest

T. Yamauchi received a scholarship Grant from Sanofi. M. Oe, K. Takehara, H. Noguchi, Y. Ohashi, A. Amemiya, H. Sakoda, R. Suzuki, K. Ueki, T. Kadowaki, and H. Sanada declare that they have no conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or a substitute for it was obtained from the patient for being included in the study.

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Oe, M., Takehara, K., Noguchi, H. et al. Thermographic findings in a case of type 2 diabetes with foot ulcer due to callus deterioration. Diabetol Int 8, 328–333 (2017). https://doi.org/10.1007/s13340-017-0315-1

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  • DOI: https://doi.org/10.1007/s13340-017-0315-1

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