Footwearrelated blisters

A 72-year-old lady with type 2 diabetes of 10 years' duration, with a rockerbottom Charcot foot treated in a total-contact cast, was issued with a new pair of special shoes. She was instructed to wear them for only 5 min/day at first, but went shopping and wore them for 2 h. She developed blisters on the side of her foot with a halo of erythema (Fig. 4.10a). The blisters were opened and drained in the diabetic foot clinic. Sterile dressings were applied and lifted every day to check for deterioration. The blisters were dry and healing well within 2 weeks (Fig. 4.10b) and fully healed within 2 months.

Key points

• Patients should receive very careful education about the timescale for rehabilitation

• New shoes should only be worn for periods of a few minutes per day, building up gradually to full-time use.

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