Association of verrucous skin lesions and skin ulcers on the feet in patients with diabetic neuropathy.

We report the simultaneous or chronological association of verrucous skin lesions and diabetic ulcers on the feet of three diabetic patients. All three patients had poor diabetic control and were suffering from complications such as neuropathy, retinopathy and nephropathy at the time of presentation. In patient 1, verrucous skin lesions on the feet in diabetic neuropathy (VSLDN) and a diabetic skin ulcer developed simultaneously. In patient 2, VSLDN preceded the development of diabetic ulcers, while in patient 3, diabetic ulcers preceded VSLDN. These associations suggest that VSLDN and diabetic ulcers are closely related in their aetiology and pathogenesis. Strategies for the treatment and prevention of VSLDN should include multiple treatment modalities combined with foot care as proposed by the international working group on the diabetic foot.