[The diabetic foot--examination of the skin]

A thorough dermatologic examination permits early identification of an increased risk for ulceration. This is of central importance in any plan to prevent amputation. Investigation should focus on the color of the skin, alteration of the texture, temperature and presence of swelling. Attention should be paid to callosities, indicating increased foot pressures, and to breaks in the skin, which may be followed by bacterial penetration. In addition, a variety of nail changes exists associated with diabetes mellitus requiring correct diagnosis and appropriate therapy.