Research development in the pathogenesis of neuropathic diabetic foot ulceration.

Neuropathic ulceration is the most prevalent type of chronic lesion of the diabetic foot. Its pathogenesis is mainly related to the abnormally increased pressure on the sole of the foot, secondary to lack of sensation and deformities induced by peripheral sensory-motor neuropathy, which are associated with an abnormal gait. The incidence of the ulcerative state is brought on by repetitive postural trauma, which causes a chronic inflammatory state, characterized by hypertrophy of skin layers and diffuse, intense inflammatory infiltrate throughout the ulcer. The off-loading of the ulcer will restore the healing process, leading to a reparative phase that will be histologically and biochemically evident.