Severe but preventable foot burn injury in diabetic patients with peripheral neuropathy

Background: Due to the sensory loss in the lower extremities, accidental foot injuries may develop in diabetic patients with distal sensorimotor polyneuropathy. Unusual etiologies of foot injury may be of interest.
Material and Method: Patient 1, a 51-year-old type 2 diabetic patient, was observed with a burn injury of the digits I-V of the right foot due to an unperceived thermal injury while working at a house construction site and wearing shoes. Patient 2, a 66-year-old type 2 diabetic patient, tried to treat a small dermal lesion caused by improper footwear by using a hot paraffin footbath, but during this unusual self-treatment a painless and unperceived burn injury developed. Bed rest, local disinfection, antibiotics, and minimal surgical intervention (partial amputation, debridement) were applied. After long healing periods, both patients recovered with acceptable residual findings.
Results:
Conclusions: Severe clinical consequences of foot burn injuries of unusual etiology may occur in diabetic patients with neuropathy. To prevent severe foot burn injuries, continuous education should be provided for diabetic patients with sensory loss of the lower extremities due to neuropathic complications.

Keywords: Diabetic Foot - physiopathology, Foot Injuries - prevention & control, Burns - prevention & control