A 67-year-old male patient with type 2 diabetes attended the outpatient diabetic foot
Figure 3.11 Varus and claw toes deformity clinic because he had developed painless hyperkeratosis on the dorsum of his toes.
He had severe peripheral sensorimotor neuropathy; peripheral pulses were normal. Significant muscle atrophy was seen on the dorsum of his feet (Figure 3.12). Mild hallux valgus and claw toes deformity were also present. As a result of a bunion (see below) due to hallux valgus deformity, a red and swollen bursa developed at the medial aspect of both first metatarsal heads, caused by pressure and friction exerted on these areas by his shoes. Painless corns were also present on the dorsum of the toes. Such corns — called heloma durum or hard corns — are a result of pressure and friction on the deformed toes caused by wearing low toe box shoes. Suitable shoes (with a broad and high toe box) were prescribed in order to accommodate the deformity. The patient did well; heloma durum and bursitis did not relapse.
A bunion is a bony prominence that develops on the inner side of the foot, near the base of the first toe. An infected ulcer
over a bunion or a heloma durum may lead to infection spreading into a joint or the bone.
Keywords: Heloma durum; bunion; bursitis; claw toe
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...