Plantar Ulcers and Neuropathic Arthropathies: Associated Diseases, Polyneuropathy Correlates, and Risk Covariates

Karen L Andrews, P. James B Dyck, Steven J. Kavros, Adrian Vella, Mohamed Kazamel, Vicki Clark, William J Litchy, Peter J Dyck, Karen A. Lodermeier, Jenny L. Davies, Rickey E. Carter, Christopher Jon Klein

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVE: To evaluate the associated diseases, polyneuropathy correlates, and risk covariates of neuropathic plantar ulcers (PUs) and neuropathic arthropathies (NAs). DESIGN: The authors conducted a retrospective, observational study over 3.5 years of 69 patients with neuropathy, NA, or PU seen in a wound clinic who also had a comprehensive neurologic evaluation and neurophysiologic testing. Comparisons were made to a population representative cohort of patients with diabetes mellitus (DM; n = 259). RESULTS: Of the 69 wound clinic patients, 32 had PUs, 14 had NAs, and 23 had both. Of the 61 adequately assessed patients, 37 (61%) had DM, 22 (36%) had no known associated disease, and 2 (3%) had hereditary sensory and autonomic neuropathy. Of the 37 patients with DM, 35 had distal polyneuropathy, and 2 did not. In 22 patients with chronic idiopathic axonal polyneuropathy, 20 had distal polyneuropathy. CONCLUSIONS: Although DM was the disease most commonly associated with PUs and NAs, chronic hyperglycemia may not have been the major underlying risk factor. The major risk covariates are sensation loss from polyneuropathy, old age, obesity, repetitive foot injury, and inadequate foot care or treatment. Physicians and other healthcare providers can help by identifying patients at risk and instituting measures such as adequate foot care to decrease these risks.

Original languageEnglish (US)
Pages (from-to)168-175
Number of pages8
JournalAdvances in skin & wound care
Volume32
Issue number4
DOIs
StatePublished - Apr 1 2019

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Foot Ulcer
Polyneuropathies
Joint Diseases
Foot
Familial Dysautonomia
Foot Injuries
Patient Advocacy
Wounds and Injuries
Hyperglycemia
Health Personnel
Nervous System
Observational Studies
Diabetes Mellitus
Retrospective Studies
Obesity
Physicians
Population

ASJC Scopus subject areas

  • Dermatology
  • Advanced and Specialized Nursing

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Plantar Ulcers and Neuropathic Arthropathies : Associated Diseases, Polyneuropathy Correlates, and Risk Covariates. / Andrews, Karen L; Dyck, P. James B; Kavros, Steven J.; Vella, Adrian; Kazamel, Mohamed; Clark, Vicki; Litchy, William J; Dyck, Peter J; Lodermeier, Karen A.; Davies, Jenny L.; Carter, Rickey E.; Klein, Christopher Jon.

In: Advances in skin & wound care, Vol. 32, No. 4, 01.04.2019, p. 168-175.

Research output: Contribution to journalArticle

Andrews, Karen L ; Dyck, P. James B ; Kavros, Steven J. ; Vella, Adrian ; Kazamel, Mohamed ; Clark, Vicki ; Litchy, William J ; Dyck, Peter J ; Lodermeier, Karen A. ; Davies, Jenny L. ; Carter, Rickey E. ; Klein, Christopher Jon. / Plantar Ulcers and Neuropathic Arthropathies : Associated Diseases, Polyneuropathy Correlates, and Risk Covariates. In: Advances in skin & wound care. 2019 ; Vol. 32, No. 4. pp. 168-175.
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