Now we are going to test for any evidence of deformity
or evidence of autonomic neuropathy or ischemia skin changes.
We will look for deformity.
As we can see, if we look at the foot as it stands,
there is a very slight deformity of the second toe overriding
the third toe.
Otherwise, this lady has very little in the way of deformity
that could be accommodated in a high street shoe,
if this was a shoe.
So that would not form much of a deformity.
If however, we now look more towards the side of foot,
you can see there's quite a lot of diffuse dryness of the skin.
This may well be in the presence of bounding pulses,
a clinical manifestation of autonomic neuropathy
where the skin is not sweating, and therefore, not lubricated.
You can see very clearly here the very dry xeroderma skin here.
So very dry skin.
There is no plantar callus on the bottom of the foot or the toes,
and importantly, we look between the toes to see
if there's any evidence of cracking or tinea pedis.
I'm pleased to say there is none.
We look between the toes.
We also look to see if there are any splits on the back of the heel,
and you can see just here there is evidence
of one trying to occur which is related to the dryness.