CUTANEOUS ERYTHEMA, WITH OR WITHOUT NECROSIS, LOCALIZED TO THE LEGS AND FEET—A LESION IN ELDERLY DIABETICS

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Abstract
The paper describes cutaneous lesions of the leg and/or foot in elderly diabetics, consisting of areas of erythema the size of a child's palm or larger, and in the same group of patients areas of necrosis from the size of confetti up to the size of a child's palm, surrounded by erythema. The necrosis involves all layers of the skin. Similar skin lesions are seen in elderly persons without recognized diabetes. When a group of patients of the latter type was compared with a control group, it appeared that their glucose tolerance was altered in a diabetic direction. The skin lesions usually follow cardiac decompensation, with or without oedema of the legs, or unilateral oedema of the leg due, for example, to venous thrombosis. The author suggests that the lesions are due to a qualitatively or quantitatively altered reaction in diabetics. The patients may also have skeletal destruction in the feet. The initial lesions in dermopathia diabetica (Melin) are also described. They consist of superficial ulcerations the size of confetti or somewhat larger, surrounded by a narrow zone of erythema.