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Venous leg ulcers account for approximately 70% of all leg ulcers and affect 2.2 million Americans annually. After a comprehensive patient and wound assessment, compression therapy remains the cornerstone of standard care. Adjuvant care with topical or systemic agents is used for wounds that do not heal within 4 weeks. Once healed, long-term compression therapy with stockings or surgical intervention will reduce the incidence of recurrence. This continuing medical education article aims to outline optimal management for patients with venous leg ulcers, highlighting the role of a multidisciplinary team in delivering high quality care.

PURPOSE To provide the practitioner with current information on the most common nail disorders. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in wound care and related disorders. OBJECTIVES After reading this article and taking this test, the reader should be able to: 1. Describe the structures that compose the nail apparatus. 2. Identify the most common nail disorders, including etiology and treatment.

ObjectiveTo determine the accuracy of audible arterial foot signals with an audible handheld Doppler ultrasound for identification of significant peripheral arterial disease as a simple, quick, and readily available bedside screening tool.MethodsTwo hundred consecutive patients referred to an interprofessional wound care clinic underwent audible handheld Doppler ultrasound of both legs. As a control and comparator, a formal bilateral lower leg vascular study including the calculation of Ankle Brachial Pressure Index and toe pressure (TP) was performed at the vascular lab. Diagnostic reliability of audible handheld Doppler ultrasound was calculated versus Ankle Brachial Pressure Index as the gold standard test.ResultsA sensitivity of 42.8%, a specificity of 97.5%, negative predictive value of 94.10%, positive predictive value of 65.22%, positive likelihood ratio of 17.52, and negative likelihood ratio of 0.59. The univariable logistic regression model had an area under the curve of 0.78. There was a statistically significant difference at the 5% level between univariable and multivariable area under the curves of the dorsalis pedis and posterior tibial models ( p ConclusionAudible handheld Doppler ultrasound proved to be a reliable, simple, rapid, and inexpensive bedside exclusion test of peripheral arterial disease in diabetic and nondiabetic patients.

Background: Despite the high burden of disease associated with hidradenitis suppurativa (HS), epidemiologic data are scarce. Objective: The objective was to review demographic features and clinical findings in 80 HS patients from 2 referral centres in Ontario, Canada, from October 2013 to September 2014, and to assess for factors that are associated with more advanced disease. Methods: Multicentre cross-sectional study. The data on demographic and clinical features were obtained by questionnaires and chart review. Results: Of a total of 80 patients (67.5% females), percentages of patients in Hurley stages I, II, and III were 15.4%, 55.8%, and 28.9%, respectively. Most patients were not diagnosed for more than 1 year (70.1%). Patients with more severe disease were more likely to be females and to have a greater number of lesions and were less likely to be diagnosed initially by a dermatologist. Conclusions: This study documents the common demographic and clinical features of HS to optimize resource allocation and patient outcomes.

Major hemoglobinopathies, including sickle cell anemia, are becoming a global health issue. Leg ulcers are the most common cutaneous manifestation of sickle cell disease and an important contributor to morbidity burden in this population. Leg ulcers following sickling disorders are extremely painful, and hard to heal. The clinical evidence for the optimal management of these ulcers is limited. Treating the cause and the strategies to prevent sickling are the mainstay of treatment. The basic principles of wound bed preparation and compression therapy is beneficial in these patients.

Our study was designed as a screening test to offer anadditionaloptiontothebedsideportableDopplerAnkleBrachial Pressure Index (ABPI). ABPI is a difficult testto perform where an active ulcer is present over the areaof blood pressure cuff occlusion, when severe local painlimits the ability to perform the ABPI test or the vesselsare non-compressible (often in persons with diabetes)due to calcification with an ABPI level of greater than1.3. In our recent study, audible handheld Dopplerultrasound (AHDU) is a reliable simple bedside toolfor the screening of peripheral arterial disease with aspecificity of 97.5% and a negative predictive value of94.1%. The inter-rater reliability of the test performedbythephysicianandthenurseperformingAHDUintheclinic was very high with 87.5% agreement. Althoughthe sensitivity of the test is only 42.8%, it is a screeningtest that combined with physical findings to determinethe need for further vascular laboratory assessment.The study by Mustapha et al.

Hidradenitis suppurativa (HS) is a chronic, recurrent, debilitating disease predominantly involving apocrine gland–bearing skin. The folliculoinfundibular dysfunction and an aberrant cutaneous immune response to commensal bacteria are recognized as potential contributors. Topical antibiotics, such as clindamycin, and keratolytic agents have been used in the management of early stages of HS. Proper wound care is a key part of management, particularly in patients with advanced HS. The evidence for the optimal topical therapy or optimal local wound care is limited. As such, a multidisciplinary approach is necessary to address all aspects of HS, including topical therapy, systemic therapy, and proper wound care. The focus of this paper is to review the evidence for the topical management and local wound care strategies in patients with HS.

Livedoid vasculopathy (LV) is a thrombo occlusive disorder presenting with recurrent painful ulcers of lower extremities. Association of LV with increased level of lipoprotein (a) (LP(a)), a risk factor for cardiovascular disease, has been reported. Danazol has been used with success in the management of LV, but none of the previous studies looked at the correlation between response to the treatment and level of LP(a). The aim of this study was to demonstrate the efficacy of low-dose danazol in the treatment of LV and its effects on LP(a). We present four cases with LV who were successfully treated with low-dose danazol, assessing the clinical characteristics and laboratory tests including the level of LP(a). The average age of the patients was 45 years and the mean duration of the disease was 19 years. The treatment regime of danazol 200 mg daily led to complete healing of ulcers and reduction in pain and a 70% (ranging from 52 to 87%) reduction in the level of LP(a). The limitation of this study is "small sample size." In our patients with LV, low-dose danazol led to clinical improvement along with significant reduction in the level of LP(a).

Diabetic foot infections (DFIs), which present with a variety of clinical manifestations, are commonly encountered by clinicians. They are associated with a high morbidity, a high amputation rate, a high mortality, and increased health care costs. An effective management of DFIs requires a multidisciplinary approach with a strong collaboration among all involved health care providers as well as patient involvement. Diagnosing DFIs appropriately requires consideration of the clinical symptoms and signs of infection in addition to supplementary laboratory testing such as inflammatory markers and imaging studies. The comprehensive patient assessment should include the predisposing risk factors for infection; the type, severity, and extent of the infection; and the assessment of neurologic and vascular status, comorbid conditions, and psychosocial factors. The comprehensive management of DFIs include not only effective antibiotic therapy but also surgical debridement, pressure offloading, wound care and moisture, maintaining good vascular perfusion, control of edema and pain, correction of metabolic abnormalities such as hyperglycemia, and addressing psychosocial and nutritional issues. Discharge planning that addresses full medical and social needs along with suitable follow-up, patient education and counseling, and clear communication with outpatient providers are critical for ensuring a safe and successful transition to outpatient management of hospitalized patients with DFIs.

Hidradenitis suppurativa (HS) is a chronic relapsing condition with a clinical picture that includes solitary nodules; diffuse, painful abscesses; malodorous drainage; sinus tract formation; and scarring. Treatment options are often unsatisfactory. The adverse effects of this disease on quality of life (QoL) is not extensively studied, especially in the Canadian population. The objectives of this study were to (1) identify the impairment of QoL in patients with HS and the aspects that are most affected, and (2) assess the correlation between disease severity (based on Hurley’s staging) and QoL impairment. This prospective case series studied 55 patients (38 females and 17 males) from community dermatology clinics in Ontario. All patients filled out the questionnaires for QoL data using the Dermatology Life Quality Index (DLQI) and the Short Form 36 Version 2 (SF-36v2) health survey, either in the clinic or over the telephone. The mean DLQI score was 10 ± 8.8, indicating a moderate effect on patients’ lives. In keeping with this, SF-36v2 scores were significantly reduced with respect to both physical and mental health. The severity of disease, as measured by Hurley staging, the number of lesions, and patient-reported QoL were significantly correlated with the DLQI score (β = 0.549, 0.285, 0.390, respectively; p = 0.000, 0.045, 0.004, respectively; α = 0.05). The impact on QoL for patients with HS is extensive yet underestimated; quantifying and assessing the burden of disease for the individual and society will lead to establishment of funding priorities and greater awareness of this condition.

Primary and metastatic malignancies may occasionally mimic or coexist with cutaneous fungal infections. The authors report 3 cases of cancers that were initially presumed to be cutaneous fungal infections. Dermatologists should maintain a low threshold for skin biopsy in patients with persistent or refractory fungal infections.

Chronic venous disease affects millions of people around the world. Venous valvular incompetencies and venous reflux, often a result of outflow obstruction are important contributors to venous disease. The prevalence of thrombophilia is increased in patients with chronic venous insufficiency (CVI). The recognition of underlying thrombophilia particularly in young patients opens new avenues in the management and prevention plan. We emphasize on the consideration of workup for coagulopathy, especially factor VIII deficiency in young patients with venous disease. We report 3 patients with chronic leg ulcers and high levels of FVIII:C activity in plasma and other associated thrombophilic factors. We highlight the need to get a workup done for thrombophilia in young patients with recurrent and chronic leg ulcers related to venous insufficiency or livedoid vasculopathy. Further studies with larger sample sizes are required to define the definite indications for the thrombophilia workups.

While hidradenitis suppurativa (HS) is not an orphan disease in terms of its prevalence, it has often been a lower priority in comparison to other dermatologic conditions in terms of notice, interest, and ongoing research. HS is a chronic,painful, inflammatory skin disease affecting a young, active population. Although genetic factors are suspected contributors, unfortunately, there are multiple uncertainties in that the etiology and pathophysiology of HS have yet to be fully elucidated. Treatments used in the management of this condition remain off-label. Traditional therapies, such as systemic antibiotics, retinoids, immunosuppressants, and antiandrogens all have been used with limited success. The phenotype of the disease has a wide spectrum, with different morphologic features. This leads us to this question: If these manifestations are within the spectrum of one disease, could we apply the same treatment algorithm to all HS phenotypes? There is a paucity of high-level evidence to support current treatments, and there are few randomized, controlled trials investigating the efficacy and safety of medical therapies in particular. The heterogeneity in clinical studies and the assessment tools make the evaluation even more difficult. The responses to treatment and clinical results have been measured by various endpoints, but there are still limited data or consensus with respect to the best tool to accurately measure the treatment outcomes. Surgery is another established treatment, particularly for patients with severe HS, but recurrence of the disease is the rule rather than the exception. The diffuse involvement of skin in certain phenotypes is a challenge for surgical therapy. Moreover, invasive surgery can lead to scarring, contractures, and reduced mobility, but conservative surgery can be inadequate to treat advanced HS. 1 Progress is being made, however, and there is cause for optimism and enthusiasm. In May of 2015, the US Food and Drug Administration designated a clinical development program for HS, such that the biologic agent (adalimumab) was granted an orphan drug designation for investigational treatment of moderate to severe HS, graded as Hurley stage II and III disease. In September 2015, adalimumab received FDA approval for the management of moderate to severe HS. Unpacking the complete story of HS remains to be done. The association of HS with the metabolic syndrome increases the burden of the disease. To what extent lifestyle modifications, such as weight control and smoking cessation, together with medical therapies will effectively manage the chronic condition remains to be explored in wellcontrolled, clinical trials. The lack of interdisciplinary care and decentralization of care have resulted in a highly variable approach to the signs and symptoms of HS with unsatisfactory outcomes. This fragmentation is also reflected by a significant diagnostic delay of 5 to 9 years in many countries, highlighting an unmet need for medical

Up to 25% of patients with diabetes will develop a foot ulcer during their lifetime with a 50-70% recurrence rate over the ensuing 5 year. Additionally more than 50% of patients with a diabetic foot ulcer (DFU) develop a diabetic foot infection (DFI). DFI remains a challenge to manage because of coexisting immunopathy. Antibiotic therapy is the main stay of treatment for patients with deep and surrounding tissue infection. A multidisciplinary approach is required with the focus on the comprehensive patient assessment, vascular assessment with revascularization, proper offloading devices and use of appropriate antimicrobials. Wound care professionals have a unique position to lessen the inappropriate use of antimicrobials.

Care of people with diabetic foot ulcers requires a systematic approach following the wound bed preparation paradigm and the existing best practice recommendations. The purpose of this article is to summarize key evidence and recommendations regarding prevention and management of diabetic foot ulcers that can be translated into practice.

Leg ulceration, often caused by venous stasis, arterial insufficiency, or both, is a common chronic health condition often associated with a prolonged healing trajectory and frequent recurrence. It is estimated that approximately 1.5 to 3.0 per 1,000 adults have active leg ulcers, and the prevalence continues to increase due to an aging population. Management of chronic edema using compression is crucial to promote healing of venous leg ulcers. The principle of compression therapy is simple, involving the use of external pressure in the forms of bandages or wraps to move the fluid from the interstitial space back into the intravascular compartment and prevent reflux. This article synthesizes and appraises the evidence for various types of compression therapies. It also addresses best practice recommendations for the management of leg ulcers when arterial circulation is considered suboptimal.

Backgrounds and Purpose: Since childbirth is a natural phenomenon and is as old as the history of humanity, man has always been involved with the problem of pregnancy and childbirth. Childbirth is one of the most important events of women's life and negative events of this event result in adverse psychological consequences for her and her family. Therefore, some solutions have been concerned to experience a pleasant childbirth and reduce pain and shorten the duration of childbirth that it would lead to a reduction in cesarean sections in women. Methods: For this purpose, an experiment was done to examine the effect of massage with jasmine oil, in comparison to aromatherapy with jasmine oil on childbirth process in Abadan city hospitals in 2013. This was a clinical experimental study. In this study, statistical population consisted of pregnant women with singleton, 18–35 year old, a low-risk pregnancy-cephalic-entering the active phase childbirth. This was a clinical experimental study. Research units consisted of mothers who were referred for delivery to hospitals of Abadan. In this study, inclusion criteria were pregnant women with singleton, term 18–35 year old a low-risk pregnancy-cephalic-entering the active phase childbirth. Totally, 120 patients were enrolled and randomly divided into one control group and two groups. Results: About the aromatherapy procedures also results from the study showed positive effects of this method in relation to the purpose of the study. What is clear is allowing the use of very simple and it should this should be done by trained personnel to achieve the best result achieved and prevent the adverse effects. What is important whenever both methods are integrated, their effects in reducing pain and anxiety are more efficiently. According to the study, it can be found that no pharmacological pain management methods that increased the tolerance of pregnant women about the pain on the one hand, on the other hand, reduce sense of loneliness and elevated and strengthened confidence to reduce the level of anxiety and fear of childbirth. At the end of researcher pointed out that the continuation of studies on the use of adjuvant therapies to have beneficial effects to those in the chain of service delivery methods on implementing methods, aware, and be more efficient. In addition the most basic proposal, its preparation as head of a team of technical education and interested, or as a partner in the form of a highly qualified team to provide technical training content “up to date” to families and pregnant women officials at the ministerial level lets by having needed information. Conclusion: During the various sessions in the country, particularly in Abadan and Khorramshahr, rates to reduce maternal mortality and to make informed choices about the health of mothers and babies and help maintain an effective delivery method.

Livedoid vasculopathy (LV) is a noninflammatory thrombotic condition presenting in a primary idiopathic or secondary subtype associated with abnormal coagulation factors. Different from atrophie blanche (AB), which is a clinical manifestation of certain scars, LV may have AB in combination with recurrent livedo reticularis with chronic and painful skin ulcers particularly around the ankle region, and at the back of the feet. Histology is characterized by segmental hyalinizing changes at the subintimal region of small dermal vessels with thrombotic occlusions. LV skin ulcers resolve with stellate, porcelain-white scars that need to be distinguished from similar changes seen with venous insufficiency. "Atrophie blanche" was originally used synonymously with "livedoid vasculopathy." AB describes spontaneously occurring porcelain-white skin areas with red dots that typically occur in the context of skin changes attributed to chronic venous insufficiency. The 2 forms of AB--(1) the LV-AB complex and (2) AB in the context of chronic venous insufficiency--are unrelated and require separate diagnostic and therapeutic approaches. Using a modified Delphi method, we have developed an international consensus document on the diagnosis and management of LV. Individual sections of this document provide advice on diagnosis and management of LV.

Diabetes mellitus is a serious, life-long condition that is the sixth leading cause of death in North America. Dermatologists frequently encounter patients with diabetes mellitus. Up to 25% of patients with diabetes mellitus will develop diabetic foot ulcers. Foot ulcer patients have an increased risk of amputation and increased mortality rate. The high-risk diabetic foot can be identified with a simplified screening, and subsequent foot ulcers can be prevented. Early recognition of the high-risk foot and timely treatment will save legs and improve patients' quality of life. Peripheral arterial disease, neuropathy, deformity, previous amputation, and infection are the main factors contributing to the development of diabetic foot ulcers. Early recognition of the high-risk foot is imperative to decrease the rates of mortality and morbidity. An interprofessional approach (ie, physicians, nurses, and foot care specialists) is often needed to support patients' needs.

The management of diabetic foot ulcers can be optimized by using an interdisciplinary team approach addressing the correctable risk factors (ie, poor vascular supply, infection control and treatment, and plantar pressure redistribution) along with optimizing local wound care. Dermatologists can initiate diabetic foot care. The first step is recognizing that a loss of skin integrity (ie, a callus, blister, or ulcer) considerably increases the risk of preventable amputations. A holistic approach to wound assessment is required. Early detection and effective management of these ulcers can reduce complications, including preventable amputations and possible mortality.

Necrobiotic xanthogranuloma is a progressive histiocytic granulomatous disease with frequent extracutaneous involvement. We have documented an unusual case of necrobiotic xanthogranuloma in a 58-year-old man with a history of recalcitrant and chronic arm and leg ulcerations in the absence of characteristic periorbital involvement. Our patient demonstrates a therapeutic challenge and may display a new necrobiotic inflammatory disorder not previously characterized.

Martorell hypertensive ischemic leg ulcer represents rapidly progressive and extremely painful ulcers that are frequently underdiagnosed. These occur most commonly on the lateral-dorsal calf and are associated with hypertension and diabetes. This article will synthesize a review of the literature for the accurate diagnosis and treatment of this painful debilitating condition.

This study aimed to highlight the importance of routine screening for hyperglycemia and to develop a standardized, evidence-based approach for the management of pemphigus patients on prolonged systemic corticosteroid (CS) therapy. A cross-sectional study was conducted in two university-affiliated teaching hospitals using a referred sample of 200 patients with a confirmed diagnosis of pemphigus vulgaris, pemphigus foliaceus, or mucous membrane pemphigoid. All patients were receiving systemic CS therapy. A total of 150 patients responded to the survey. Six participants were excluded and 144 were included. The main outcome measure was blood glucose level to detect hyperglycemia. New-onset hyperglycemia was identified in 40% of patients who received CS therapy. None of the expected variables, including age, body mass index, family history of diabetes, corticosteroid dose, and duration of corticosteroid therapy, were independently associated with new-onset hyperglycemia. These findings indicate that the prevalence of CS-induced hyperglycemia in pemphigus patients is 40% and that in patients with pemphigus or MMP, CS therapy is associated with a markedly increased risk for hyperglycemia (odds ratio = 10.7, 95% confidence interval 1.38-83.50) compared with that of patients with the same diseases who do not receive CS therapy.

People with diabetes mellitus will develop lower-limb complications, such as neuropathy, peripheral vascular disease, foot ulcers, and lower-leg amputations. Resources to control elevated haemoglobin A 1c and blood pressure, along with the standardised approach using the 60-second tool (2012) © , can detect the high-risk diabetic foot and help prevent complications.

This study describes the impact of diabetic foot ulcers (DFUs) on health-related quality of life (HRQoL) using a generic instrument including 8 domains. Data were obtained from 54 patients with DFU who were compared with 78 patients who had diabetes without foot ulcer. HRQoL was measured using the Iranian version of Medical Outcome Study–Short Form (SF-36). The fasting plasma glucose, creatinine, glycosylated hemoglobin (HbA1c), and urine microalbumin as well as ankle-brachial pressure index (ABI) were measured for all participants in the 2 groups. In all, 51.9% of patients with DFU had ABI scores of

Thyroid gland produces thyroid hormones to help the regulation of the body's metabolism. The abnormalities of producing thyroid hormones are divided into two categories. Hypothyroidism which is related to production of insufficient thyroid hormone and hyperthyroidism related to production of excessive thyroid hormone. Separating these two diseases is very important for thyroid diagnosis. Therefore support vector machines and probabilistic neural network are proposed to classification. These methods rely mostly on powerful classification algorithms to deal with redundant and irrelevant features. In this paper feature selection is argued as an important problem via diagnosis and demonstrate that GAs provide a simple, general and powerful framework for selecting good subsets of features leading to improved diagnosis rates. Thyroid disease datasets are taken from UCI machine learning dataset.

Past work on face detection has emphasized the issues of feature extraction and classification, however, less attention has been given on the critical issue of feature selection. We consider the problem of face and non-face classification from frontal facial images using feature selection and neural networks. We argue that feature selection is an important issue in face and non-face classification. Automatic feature subset selection distinguishes the proposed method from previous face classification approaches. First, Principal Component Analysis (PCA) is used to represent each image as a feature vector (i.e., eigen-features) in a low-dimensional space, spanned by the eigenvectors of the covariance matrix of the training images (i.e., coefficients of the linear expansion).Then we consider Linear Discrimination Analysis (LDA) to achieve a comparison result between these two methods of dimension reduction. Genetic Algorithm (GA) is then used to select a subset of features from the low-dimensional representation by removing certain eigenvectors that do not seem to encode important information about face. Finally, a Probabilistic Neural Network (PNN) is trained to perform face classification using the selected eigen-feature subset. Experimental results demonstrate a significant improvement in error rate reduction.

Individuals with chronic leg ulcers often develop contact allergic reactions to topical preparations used to treat their wounds and the surrounding skin. The objective of this study was to determine the frequency of positive patch test responses to common allergens in patients with leg ulcers or venous disease. A case series of 100 consecutive, consenting patients with chronic venous disease and other causes of leg ulcers that were available for patch testing were enrolled. The patients were tested with 38 common allergens, including those most relevant to leg ulcers. A total of 46% of the patients had at least 1 positive patch test response. Multiple reactions in the same patient were common. The most frequent groups of sensitizers were fragrances, lanolin, antibacterial agents, and rubber-related allergens. Though the prevalence of positive patch test reactions is high in this population, it is lower than commonly reported. This may be the result of clinical practice that considered the avoidance of common sensitizers in the management of patients with leg ulcers.

Iran is a Middle Eastern country whose borders include the Caspian Sea, Azerbaijan, and Turkmenistan in the north; Turkey and Iraq in the west; Pakistan and Afghanistan in the east; and the Persian Gulf and the Gulf of Oman in the south. It has a population of nearly 70 million, and Islam is its primary religion. I was born in the southeastern Iranian province of Kerman, and I trained as a dermatologist. My training, however, was not adequate to manage the many wound problems I was seeing among my patients. This lack of expertise in wound management was not the only barrier to adequate care. Iran has a long way to go to change customs, create interprofessional care teams, and translate the evidence base in wound care into practice. Diabetic foot ulcers and pressure ulcers are the 2 major wound types I have encountered while practicing in Iran. In this article, I will define the problems and examine the progress that has been made in upgrading practice in the country.

Background Cutaneous leishmaniasis is a common disease in Iran, particularly in Kerman province. It usually occurs via the bite of an infected sandfly. Methods One hundred and fifty patients suffering from cutaneous leishmaniasis were included in this study in Kerman. The patients were randomly divided into three groups. They were matched with regard to age, sex, duration of the disease, and type, number, and site of the lesions. For each group, one of the following therapeutic methods was applied: (i) oral allopurinol (15 mg/kg/day) for 3 weeks; (ii) intramuscular injection of Glucantime (30 mg/kg/day), corresponding to 8 mg/kg/day of pentavalent antimony, for 2 weeks; (iii) combined therapy. The lesions were re-examined at the end of treatment and 2 and 4 weeks later. The response to treatment was graded as excellent (reduction in the size of the lesion by at least 80% or complete clearance), good (reduction in the size of the lesion by 50%), and poor (minimal or no change in the lesion). Results The overall results indicated that 18% of patients showed excellent response, 6% good response, and 76% poor response in the first group. In the second group, 24% of patients showed excellent response, 6% good response, and 70% poor response. In the third group, 46% of patients showed excellent response, 8% good response, and 46% poor response. Conclusions The results obtained by the three therapeutic methods indicated that combined therapy with allopurinol plus Glucantime was much more effective than that obtained by each of the two drugs when used alone (P

Diabetes mellitus is a serious, life-long condition that is the sixth leading cause of death in North America. Dermatologists frequently encounter patients with diabetes mellitus. Up to 25% of patients with diabetes mellitus will develop diabetic foot ulcers. Foot ulcer patients have an increased risk of amputation and increased mortality rate. The high-risk diabetic foot can be identified with a simplified screening, and subsequent foot ulcers can be prevented. Early recognition of the high-risk foot and timely treatment will save legs and improve patients' quality of life. Peripheral arterial disease, neuropathy, deformity, previous amputation, and infection are the main factors contributing to the development of diabetic foot ulcers. Early recognition of the high-risk foot is imperative to decrease the rates of mortality and morbidity. An interprofessional approach (ie, physicians, nurses, and foot care specialists) is often needed to support patients' needs.