Foot Care from A to Z

Thomas P. Lyman, BS; Tracey C. Vlahovic, DPM, FAPWCA

Disclosures

Dermatology Nursing 

In This Article

Peripheral Neuropathy

Peripheral neuropathy is typically associated with diabetes mellitus but may also be linked to antiretroviral medications or long-term alcohol abuse. Neuropathy is damage to the peripheral nerves and can be a motor or sensory problem. The typical presentation is a loss of protective sensation. The basic test for protective sensation is done in the clinical setting with a Semmes Weinstein 5.07 monofilament (Armstrong, Lavery, Vela, Quebedeaux, & Fleischli, 1998). The monofilament is placed on the foot in ten locations, mostly plantar foot, and the patient is asked if he feels all or most of them. Corns and calluses can skew the results as the thickened skin will perceive the monofilament less than non-callused skin. When neuropathy is found, the patient is at risk for plantar foot ulcers and should be monitored regularly. For long-term painful neuropathic control (sharp, radiating pain), the best method to curtail future problems is to control the blood sugar. Other treatments consist of capsaicin cream to reduce substance P, oral gabapentin, oral pregabalin, lidocaine patches, and/or other pain-controlling agents.

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