Diagnosing A Pruritic Skin Lesion In

    A Patient With Diabetes And Edema


A 56-year-old man presented to our institution with the chief complaint of a scaly, pruritic lesion on the lateral aspect of his left lower leg. He would notice some mild bleeding when scratching the area. He denied having any other lesions on his body and there was no previous treatment.


The patient’s past medical history included type 2 diabetes with Charcot arthropathy and neuropathy, hypertension, atrial fibrillation, and deep venous thrombosis. His past surgical history was remarkable for cardiac ablation. The patient is married and does not use tobacco products. He admitted to rare consumption of alcohol.


The patient’s physical exam revealed a man who appeared healthy. The pedal pulses were palpable with capillary refill in less than two seconds to the digits. Mild edema and varicosities were present at the ankle region bilaterally. The neurologic exam with the 10-gram Semmes-Weinstein monofilament showed decreased sensation to the dorsal and plantar aspects of both feet … read more