The onset of a foot lesion can almost always be traced to an injury or trauma of some kind--physical, thermal, or chemical. Many are originally minor injuries that the patient, family, doctor, or other health professional considers trivial. Systemic indicators are frequently blunted in the elderly. Except in the most severe infections, elevations of temperature and white blood cell count may be absent, and frequently the only signs of ongoing infection are a slowly falling hematocrit and increasing difficulty of diabetic control.
