Thermal imaging of skin changes on the feet of type II diabetics

Skin changes such as callosities and mycosis may be regarded as a risk factor for severe structural impairments including ulcers and osteomyelitis in patients suffering from diabetes. Increased temperature of the feet of diabetics is another frequent finding. We investigated the relationship between skin changes and areas of increased skin temperature recorded with an Infrared Scanner AGEMA 870. 76 patients who had type 2 diabetes longer than 5 years, were studied. A physical examination of their feet and nerve conduction tests were performed. Thermal images were taken from both legs in the anterior view, the foot from an anterior view and the soles. 230 sites of high temperature (hot spots) were detected on the thermal images of 75 soles. Toe deformities or deformity of the anterior foot arch, skin callosities, onychomycosis were not related to hot spots on the sole. We confirm that about half of type II diabetes patients present with increased temperatures of their feet. However, no relationship with skin changes and areas of elevated skin temperature could be established. Thermal imaging does not identify the common skin changes found in the feet of diabetics.