Neuropathic ulcers: a focused review

Neuropathic ulcers or diabetic foot ulcers are preventable ulcers associated with diabetes mellitus. These ulcers occur in the setting of unrecognized trauma, peripheral neuropathy, and foot deformities; however, they are often complicated by peripheral arterial disease and infection. Approximately 15% of individuals with a neuropathic ulcer require limb amputation as a result of infection. Not only are neuropathic ulcers a burden to the patient but also to the economy. The cost of diabetic foot ulcer care is approximately $1.38 billion per year. This makes neuropathic ulcers an important therapeutic target. This review presents the pathophysiology, clinical presentation, evaluation, management, and prevention of neuropathic ulcers.